Sketchbook archaeology: Bodies multiple and the archives they create

Introduction

This article is an attempt to “slow down” the process of discovery in (bio)archaeology. To do so requires moving in and out of assemblages of people, things, ideas, and forces in different places and times. Such a process involves encounter and production, something Gavin Lucas (2012: 18) characterizes as “historical evidence in the form of archaeological archives.” The archaeological record as archive, he argues, can refer to what we might find in the ground as well as our notes, drawings, photographs, and other media produced during fieldwork. “Such records or archives—not the actual remains themselves—in many ways form the principal basis of interpretation” (Lucas, 2012: 18). Archaeologists, therefore, “work on texts and documents as much as objects and deposits in their” studies (Lucas, 2012: 18).

The irony of this, as Lucas further points out, is that archaeologists surrendered these sources to historians over a century ago to become an independent science. When historical archaeology emerged in the 1960s, anxiety loomed once again around documents and archival sources. Rather than be a handmaiden to history (Hume, 1964), these budding specialists set themselves apart by separating texts from things (Lucas, 2012). Their main data sources became the “small things forgotten” (Deetz, 1977) and “those of little note” (Scott, 1994)—things characterized as missing or neglected in historical records. Thus, while “archaeologists may cite texts and other sources as useful to the archaeologist, there is a clear sense that these are not part of the archaeological record” (Lucas, 2012: 22). Absence, therefore, has work to do in the winnowing of specialists and the kinds of knowledge they might create.

So wherein lies the body in this entangled archival web? It has been over a decade now since Joanna Sofaer (2006: 25) laid bare the “osteo” and “archaeology” divide. “Though we talk about ‘the body,’” she writes, “it is a fragmented and disputed entity.” Not unlike pots or other artifacts, the material properties of bodies account for their plasticity and malleability, Sofaer demonstrates, as well as their physical limits and constraints. Importantly, these affordances vary across the life course. Processes of growth, maintenance, and senescence influence interactions within wider social and material worlds while, at the same time, these relations become incorporated into the body. Bodies, therefore, are always in the process of becoming; moreover, they are always social and historical. “We literally embody our history,” Sofaer (2006: 77) argues, “and because our history is created through our relations with others, we also embody the history of our relations with them, thereby tapping into their histories too.” Her relational approach challenged the many dichotomies and divides that forced archaeological bodies apart, including the specialists who study them.

Since this time, bioarchaeologists have been busy drawing social theory into their work (e.g., Agarwal and Glencross, 2011; Baadsgaard et al., 2017; Cheverko et al., 2020; Crandall and Martin, 2014; Geller, 2021; Gowland and Knüsel, 2006; Watkins, 2021), along with other documents and material sources (e.g., Hosek and Robb, 2019; Hosek et al., 2021; Lans, 2021; Mant and Holland, 2016; Mant et al., 2021; Mitchell, 2017; Novak, 2020; Perry, 2007; Roberts, 2011; Watkins and Muller, 2015). For many bioarchaeologists, and like their archaeologist counterparts, there is a clear sense that these things are not part of the osteological record. Though they may talk about “reading the body” as text, the real evidence is found in human remains (Crossland, 2009). Thus, when it comes to making a case, bone leads. Other materials follow.

Take for example a recent study of violence and trauma in medieval England (Grauer and Miller, 2017). It is important to note that I use this publication as representative of a wider trend. Indeed, it is a thought-provoking article, which the researchers (Grauer and Miller, 2017: 41) characterize as a “provocative attempt” to synthesize historical records and human skeletal remains as complementary data. The scholars carefully consider the biases inherent to both documents and bone, as well as the ways one source might question, complement, or flesh out inadequacies in the other. However, at a pivotal point in their argument, this laudatory attempt at symmetry falls back on hierarchies of value. “Human remains,” they write, “stand in stark contrast to most all other historical resources: they have not been created or manufactured by humans; they are humans” (Grauer and Miller, 2017: 41). This kind of statement is not unusual in skeletal studies, even with a resurgence of interest in how to integrate “disparate things” (Mant and Holland, 2016; Mant et al., 2021; Robb et al., 2019). Still the problem remains, as Lucas (2012) points out, that the ontological status of our material sources—the many tissues and types—persist in our studies unexamined. “Ontology,” Harris and Robb (2012: 668) remind us, “is a fundamental set of understandings about how the world is: what kinds of beings, processes, and qualities could potentially exist and how these relate to each other.”

With these considerations, if we return to Grauer and Miller’s study above and closely examine what they characterize as two “different” sources, the gap between historical records and human skeletal remains shifts, offering opportunities to explore alternative questions. The “documentary” source they (Grauer and Miller 2017: 14) use is the recently translated and digitized Calendar of the Patent Rolls, a 32-volume compilation of diverse records that span 220 years of English history. While these materials and their transformation into a mobile medium are worthy of an in-depth discussion (see Caraher, 2019; Gitelman, 2014; Leonelli and Tempini, 2020), it is the “skeletal” source that I want to focus on. Grauer and Miller (2017: 41) describe these materials as being comprised of “primary data collected from 1,014 skeletons,” to which they add data “gleaned from published and unpublished archaeological site reports, and published books and articles generated from the excavation of English cemeteries.” Rather than a pure, unmanufactured source, an array of tissues and practices populate this sample.

The reports, books, and articles that were mined for skeletal data were written by researchers who excavated and analyzed archaeological bodies from an array of places and earlier times under the auspices of different institutions, agencies, and regulations. Within these documents were numbers and descriptions, written on paper and printed in ink, compiled into tables for ease of access. Photographs and illustrations serve to complement these writings, filling out the multimedia collage. Even the primary data from the skeletons themselves could not be collected alone. Museum collections and curators, calipers and forms, discussions and descriptions assemble under one name: skeletal data. This sample, therefore, is undoubtedly a composite material, but not in the way osteologists typically think of it (i.e., collagen and hydroxyapatite).

“The body,” in this light, is as fractured and disputed as Sofaer highlighted so many years ago. Indeed, what a body “is,” or data “are,” appears unstable. This is a big black box that needs some unpacking. While the turn to ontology has been widely debated within archaeology, much of this has involved what Alberti (2016: 175; emphasis added) describes as “working with our materials in such a way that maximizes the potential for ontological differences to emerge.” Other scholars, including Lucas (2012), Harris and Robb (2012), and Fowler (2013) offer approaches that leave the ontological status of an object more ambiguous. Instead, they attend to encounters and practices within which entities materialize relationally. Such an approach is influenced by feminist scholars who have long argued that most things are multiple, partial, and performed (e.g., Barad, 2007; Butler, 1990; Gero, 1996; Haraway, 1988; Mol, 2002; Stengers, 2018; Strathern, 2004; Wynter, 2003). ¹ This acknowledgement alone creates an ontological shift in our understanding about what an archaeological body is and might become.

Such a shift, however, requires doing differently, including moving away from dichotomizing our sources as basically raw or cooked—as what is or what is made in the world (Biruk, 2018). This will involve not only a change in practice but working at different tempos and speeds. “Another science is possible,” philosopher of science Isabelle Stengers (2018: 98) insists, but it will require “a deep break with the ideal of academic science shaped during the 19th century, a model that promoted as a general ideal the fast, cumulative advance of disciplinary knowledge along with a correlated disregard for any question that would slow this advance down.” Following Whitehead (1967 [1925]: 207), Stengers (2018: 47) encourages scholars to wander and wonder, “to appreciate the landscape that situates them, instead of passing through it at top speed” (see also Cunningham and MacEachern, 2016). By slowing down and participating in our assemblages, rather than probing them from afar, a different kind of knowledge is possible. Such knowing will be partial and incomplete, but informative in ways difficult to index or measure. To make space for doubt and allow difference to persist, Stengers proposes an “ecology of partial connections.” This involves “learning from others, being transformed by what is learned, and acknowledging our debt to this transformative experience as we explore its problematizing impact in our own terms” (Stengers, 2018: 127).

Rather than begin with dichotomized material sources (bone/documents) that prop up disciplinary domains (science/humanities), if we turn instead to practice—what gets done with whom, how, and with what—the boundaries, as we’ve seen, get rather fuzzy. In this way, Annemarie Mol (2002: 157) lays the methodological groundwork for the remainder of this article:

If practice becomes our entrance into the world, ontology is no longer a monist whole. Ontology-in-practice is multiple. Objects cannot be aligned from small to big, from simple to complex. Their relations are the intricate ones that we find between practices. Instead of being piled up in a pyramid, they rather relate like the pages in a sketch book. Each new page may yield a different image, made with a different technique and in as far as a scale is recognizable, it may again, each time, be a different one.

To explore what an archaeological body is and might become—how multitudes can fall under one name—I follow the proliferation of “cancer” from the Spring Street Presbyterian Church burial vaults (ca. 1820–1850) in Manhattan, which were inadvertently unearthed during construction in 2007 (Mooney, 2010). The commingled skeletal remains, soils, and burial artifacts would make their way to my lab, sporadically, at later dates. “Cancer,” too, would materialize in different places, times, and forms, making it a difficult to get a grip on this entity. Currently, my sketchbook—an archive—of “cancer” multiple has become rather large and unwieldy, but such is the nature of this kind of work. Rather than start at the beginning, which itself is a problematic place to define, I offer a short vignette to illustrate how difference can materialize, side-by-side.

The many and the one

It didn’t take long to lay out the skeleton from Burial 9. A facial fragment here, a bit of forearm there; pelvic bones in the middle. From here, elements of the legs were placed, anatomically, on the padded tabletop. This was all that remained of a middle-aged male who was excavated from the historic Spring Street Presbyterian Church (SSPC) burial vaults in lower Manhattan, New York (Figure 1). In December of 2006, construction of the Trump Soho condominium complex exposed four burial chambers and initiated a multi-agency scramble to remove their contents (Mooney, 2010). Burial 9 was just one of the many hundred decedents interred there during the first half of the 19^th century (ca. 1820–1850). His excavated remains, along with those of at least 197 commingled others, would eventually make their way to my lab in Syracuse, New York (Novak, 2017a).OPEN IN VIEWER

Laying out Burial 9, as he had come to be known on forms, photos, and radiographs, was by now a familiar process. His body—or at least some of its parts—had attracted special attention because of the unusual conditions it displayed. Across the internal (visceral) surface of his pelvis, a layer of spiculated bone had formed, creating a velvety, moss-like appearance (Figure 2(a)). At the same time, these elements were also pitted with lesions, making them appear moth-eaten. This condition was familiar to me from other skeletal remains I had encountered over the years and come to understand as metastatic carcinoma—prostate cancer, in particular (Ghabili et al., 2016; Klaus, 2018; Rando and Waldron, 2018).OPEN IN VIEWER

Bringing Burial 9 out of storage and back onto the bench was preparation for a consultation with an orthopedic oncologist from the nearby medical school. A soft knock on the door and Dr. Gray ² enters my lab. “Let’s see what you’ve got,” he says. Hands on khaki hips, the middle-aged surgeon stands over the bones, glances at them briefly, and then asks, “Do you have films?” “Of course,” I reply, handing him the contents of a large manila sleeve. Gray holds the inky transparency up to the light, studies it for a few seconds, and, before looking away, says, “Oh yeah, that’s prostate cancer” (Figure 2(b)). Pivoting back to the table, he waves his free hand back and forth over the bones, and asks, “What’s this?”

To contemplate the body’s many forms and afflictions highlighted in the vignette above, let’s return to the salient work of Annemarie Mol, who introduced the notion of multiplicity and multiple objects. ³ Simply put, if the question “Which entity?” is raised, the ontological answer, Mol (2002: vii) argues, must be “a slightly different one each time.” To illustrate, she closely follows a common disease, atherosclerosis, through daily diagnoses and treatments in a Dutch hospital. Rather than observing a single disease perceived in different ways, what she finds is an entity that refuses to stabilize in one form or another. From one place and time, specialty and apparatus, an alternative “atherosclerosis” is probed and measured, imaged and diagnosed, treated and stripped away (Mol, 2002). A person visits a clinic where they describe problems and pains; a clinician palpates a patient’s leg to delineate the affliction and order more tests; a cuff and Doppler apparatus is attached to the ankle that produces rhythmic sounds of blood flowing beneath the skin; an amputated leg is dissected to reveal thickened tissue under a microscope. If you were to ask participants in this process to point to atherosclerosis, fingers would move in many directions. As objects are brought into articulation with other people, things, places, and ideas, “a single object may appear to be more than one” (Mol, 2002: vii). Rather than simply bringing different perspectives to matters at hand, these things are more active and in flux, enacted and altered in practice.

If we return to the encounter in my lab with these considerations in mind, recall that the surgeon and I met to discuss cancer, particularly as it is expressed in human bone. We shared a similar language of anatomy (Mol, 2002: 48) and had no problem communicating in this way. And yet, when we met in the lab that day, we clearly did not see the same thing. Typically, this difference would be treated epistemologically. People have different vantage points on the same reality, and their divergent interpretations can be explained in terms of personal histories and social positioning. Epistemology alone, however, cannot account for conflicting (or complementary) versions of what is assumed to be the same phenomenon. Mol’s ontological approach involves shifting our focus solely from the knower to the material traces themselves and the multiple forms they can take. ⁴ For Dr. Gray, the plastic radiographs and patterns of transparency illuminated by a ceiling light were prostate cancer. For me, the bone anomalies on Burial 9 laid out on the table were prostate cancer. For a moment, at least, cancer was multiple—so too was reality.

This encounter was by no means a clash of worldviews, or cultures as they used to be called, but a fleeting glimpse into alterity. Though not as provocative as shamans transforming into reindeer, this enactment troubles, nonetheless, the persistent Western/non-Western dichotomy that props up most ontological inquiries (Bertoni, 2012; Harris and Robb, 2012). Importantly, as medical anthropologists Cohn and Lynch (2017: 136) emphasize, “[t]he juxtaposition of these realities may not always be in terms of cultural differences across large distances.” Rather, it is “often the close and proximal ways in which diverse ontologies sometimes contradict, sometimes cohere, and at times manifestly compete with each other” (Cohn and Lynch, 2017: 136). Alterity, therefore, may not be as radical as portrayed, but simply the norm (Graeber, 2015). To recognize contradictions and coherence, we must avoid fixating on moments of difference, to “freeze-frame” (Latour, 2010) events or entities, satisfied that difference is defined. Doing so, Harris and Robb (2012: 668–669) caution, can elide partial similarities, individual variability, and change through time.

Dr. Gray and I shared enough in our perceptions and expectations about what a “body” or “cancer” could be that it kept our encounter from becoming incoherent or dissolving into dispute. And perhaps more importantly, while the distinctions between our observations were ontological, there was no need to pit one against the other. The accuracy of both can be acknowledged without debating which one is “really” true (Harris and Robb, 2012: 676). The lack of controversy or conflict, however, does not imply consensus. In fact, this collegial encounter may have turned out quite differently had it not been for other things being in place. The laboratory space, presentation of bones, and availability of “films” provided an assemblage of credibility within which to take things seriously. A “theatre of proof” (Latour, 1988: 85–87) was established before the surgeon arrived. “The stage props are as important as the people,” Mol (2002: 32) notes, “because, after all, they set the stage.”

Mol’s staging, however, differs somewhat from that set by Goffman (1959) and other dramaturgical scholars. Her enactments, as she calls them, are collaborative affairs that need not be instigated by humans: “Activities take place—but it leaves the actors vague” (Mol, 2002: 33). Any disease—atherosclerosis, cancer, and others yet to be named—is, therefore, part and parcel of that which enacts it: materially, spatially, and temporally. “Different enactments of a disease entail different ontologies. They each do the body differently” (Mol, 2002: 276). Indeed, with so much alterity on the loose, the real challenge may be recognizing the way difference hangs together (Domínguez Rubio, 2016; Graeber, 2015). What better undisciplined entity than cancer, then, to explore the many and the one (Arnold-Forster, 2020; Jain, 2013; Lock, 1998; McMullin, 2016).

Separation practices

Analysis of the Spring Street skeletal remains continued well beyond my meeting with Dr. Gray. In the process, two additional decedents’ remains were found to display anomalies consistent with metastasized cancer. Like Burial 9, Individual C was the incomplete skeleton of a middle-aged male, whose pelvic bones were marked by similar, anomalous changes. ⁵ The skeletal remains from Burial 8, however, were different in significant ways. These were the nearly complete remains of an older adult female, a woman whose bones were riddled with lytic lesions from head to foot (Figure 3(a)). According to Dr. Stevenson, ⁶ the radiologist who closely examined digital X-ray and CAT-scan images of her bones, “This is metastatic breast cancer” (Figure 3(b)).OPEN IN VIEWER

My consultation with this specialist, unlike the one with Dr. Gray, took place outside of my element. Traveling to a medical facility some distance from campus, the imaging process there involved another finely choreographed performance—another enactment. It required carefully packing and transporting select bones to the business after hours, and coordinating with technicians, equipment, safety devices, and the like. Foam wedges were used to position bones anatomically, compensating for the soft tissue that was long gone; lead numbers and scales were included, so as not to mix up people and their parts. Huddled behind a safety wall, settings adjusted, and, with the push of a button, X-rays released. The hum of the machine made their invisible presence known. Flecks of bone dust were brushed from the tabletop in preparation for the next item on the list. When finished, this “technology-in-practice assemblage” (Attewell, 2016: 5) traveled, electronically, to the doctor’s office at the other end of the hall. It arrived before we did, having to make the short walk. Different elements of this assemblage moved at different speeds, creating an opportunity for disaggregation and some things to be left behind.

Dr. Stevenson sat in a multi-screened room evaluating images of patients from earlier in the day. A self-described history buff, the radiologist was delighted to help with the project, though he rarely, if ever, mingled with the tissues we brought. Here, disease was enacted without having to interact with flesh or bone. Smooth, two-dimensional shades of gray were privileged over the ragged tissues down the hall. Separation practices were built into this space. It helped ensure that bodies and diseases multiple could persist, enacted here and there, under one roof. In such places and times, an entity like cancer can simply be incoherent. Reality is distributed by physically separating things that might otherwise clash (Mol, 2002: 115).

This enactment contrasts with how the surgeon, Dr. Gray, confronted unfamiliar materials in my lab. To reconcile the discrepancy, an assemblage of words, bones, textures, and touch brought the two things closer together. They became more coherent through at least partial connections (Stengers, 2018; Strathern, 2004). “Huh, so that’s what it looks like,” was Gray’s response, suggesting that “this,” as he called it with the wave of a hand, was no longer a problem. Mol (2002: 69) describes this kind of coordination as additive, whereby new things are made together. At the radiologist’s office, Dr. Stevenson simply had his technician transfer images to a disc that we could take back to campus with us. The separation practice in his office—flesh and bone from image on screen—was reinforced by some 40 miles of farmland and highway to the west. In this way, bodies and diseases multiple simply carry on, untroubled by incoherence. Gaps can remain without conflict or consensus; they are simply let be. “They are lived with” (Mol, 2002: 87).

At the same time, what we brought back to the lab was a complex bundle of mobile data—a technology-in-assemblage-practice on the move. Together with the bones, photographs, analysis forms, burial artifacts, and the like, a different but not entirely new Burial 8 was emerging. Rather than a hybrid object, this body, this disease, this person—called by one name, “Burial 8”—was an emergent assemblage of materials and practices, each with its own histories of encounter and loss, transformation, and doings along the way. This composite material is not simply additive, but relational and multiple with many moving parts. Some might take us to other places and times—if, that is, we are willing to follow.

Paper bodies

Still other “diseased” tissues from Spring Street emerged, although this time on paper and in ink (Figure 4). The Manhattan Registers of Death, (1795-1865) contain thousands of entries in handwritten text that detail people and their passing. For each decedent, select information was noted on a single line in a ledger: date of death by day, month, and year; last and first name; residence; age in years, months, and days; place of nativity; disease; cemetery; sexton; and remarks. While these data are abstracted from daily life and life courses, intimate details can still be read within and beyond this space (Ellis, 2020; Farge, 2013; Stoler, 2010). This might even include the ledger itself, whose earliest entries are found under column headers that are captioned in handwritten text. In these humble, material traces can be seen the creep of biopolitics (Foucault, 1978). Indeed, by 1837, the document had taken a standardized printed form—an anonymous, bureaucratic system was materializing.OPEN IN VIEWER

Still other marks of humanity haunt these pages—flesh and bone in motion, leaving traces in ink. While the clerks who entered the vital data are unnamed, I came to know some of them through their script—the distinct loops and swirls, abbreviations, and annotation quirks. One person caused me nothing but grief for the days they were on duty. ⁷ Thus, for those entries that were legible, 657 people were identified as having been interred in the Spring Street Presbyterian Church burial vaults during the 30 years when they were active. This body count intervenes in previous estimates from bone (n = 297), which requires careful consideration. But it is the historical documents that most practitioners continue to view with greater suspicion—too many mediators, politics, and forms of power intervene to consider them a reliable source. The books, so to speak, are cooked.

Recently, Robb and colleagues (2019) have emphasized what textual sources lack—women and children, the colonized and subaltern, those “peoples without history” (Wolf, 1982). “[W]e are far more likely to encounter a woman, a child, or a poor person in the grave than on the page,” they write (Robb et al., 2019: 29). Yet in the case of Spring Street, such a blanket statement does not hold up, nor does it serve our inquiry well. In fact, these “kinds” of people populate the pages of the Manhattan Registers of Death in dramatic numbers. There was, for example, 54-year-old Charlotte Cook (1785–1839), one of the blessed few whose “disease” was listed as a “visit of God.” None of the others buried in the church vaults would be so fortunate, including the four decedents whose deaths are attributed to cancer (Table 1).

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Table 1.

Four cases of “cancer” identified in the Manhattan Registers of Death for decedents interred in the Spring Street Presbyterian Church burial vaults (1820-1850).

Date of decease	Names	Residence	Age	Place of nativity	Disease
Feb. 6, 1828	Chamberlain, Mary Ann	Broadway	31	Virginia	Cancer of the stomach
Jan. 20, 1830	Marvin, Ann H.	321 Hudson St.	45	New York	Cancer
Aug. 27, 1837	Simpson, Abby	164 4th St.	34	New Jersey	Tumour
May 28, 1843	Rider, Catherine	65 Vandam	64	New York	Cancer of the breast

One of these entries is listed simply as “cancer,” another a “tumour,” while two others are more specific about the diseased organ: stomach and breast. Notably, all four of these entries are for women. Their bodies—this female body—was considered ontologically distinct, and more susceptible to runaway growth. The ebb and flow of substances across her life course—menstruation, pregnancy, childbirth, lactation, and menopause—disrupted the body’s equilibrium (Rosenberg, 1977; Skuse, 2015).

Throughout antiquity, the breast—linked to the uterus—was a most troublesome site; it was a visible entity that both life and death could latch onto. From the early modern period on, Alanna Skuse (2015: 40) argues, “women’s cancers sprang from, and in turn re-inscribed, a model of sexual dimorphism in which the female body appeared physiologically, functionally and pathologically unique” (see also O’Connor, 2000). Men’s cancers, Skuse (2015) adds, especially sex-related forms, are far less common in historical texts. A notable exception is scrotal cancer, recognized in 1775 as an occupational carcinoma in London’s chimney sweeps (Cassileth, 1983: 363). At the same time, while “women’s cancers” were considered a peculiar pathology inherent to their kind of body, cancer in men was understood as the result of bad diet, bad humours, or simply bad luck (Skuse, 2015: 45).

The breast and scrotum are materials lived with, differentially at times, across variable life course continuums. When change is recognized, a categorical shift might take place, say from child to adolescent; wife to mother; healthy to diseased; corpse to skeleton. However, transitioning from “this” to “that” is no easy task; work is required to make a difference. People and things must be set in motion, in material-real ways through relational practices. A lump, dimple, or bruise to the breast does not become cancer at once or on its own. It requires gathering and collaborating with others.

In the first half of the 19^th century, a physician might be called to the home, but only by those who could afford it (Koblenz, 2013). Touching and talking, interrogating flesh and family histories, a course of action was negotiated. While physicians are endowed with a power to prescribe, this cannot be done alone—it requires doing with a “patient-body” (Mol, 2002: 23–24). Only then might chemicals and contraptions be mobilized to abate the growth found surfacing in a woman’s body. In his widely circulated treatise, On the Nature and Treatment of Cancer, Irish physician Walter H. Walshe (1846: 513) recommended the “internal use of arsenic” along with a topical “lead-ointment, and compression with the slack air-cushion apparatus.” He acknowledged, however, that these acts would only prolong the inevitable. Enacting cancer also meant transitioning a living body into a dead one.

Though the prognosis was dim, and a cure remained elusive, there was one thing Walshe (1846: 180) was sure of: “There is no fact in the history of cancer more absolutely demonstrated than the influence exercised by sex on its development.” He supports this fact using statistical data drawn from mortuary registers in Paris and national statistics of disease compiled by the British government (Moscucci, 2005: 1313). “To enact a disease is also to enact norms and standards,” the substrate of which is the who and the what (Mol, 2002: 121). “The population,” in this light, was becoming a new entity in the physician’s toolkit. The “who” being women, the “what” breast cancer, and together as data they established a fact. Culled from local biologies, once situated in space and time, this new entity on paper could travel. “Data are, first and foremost, material artifacts,” Leonelli (2015: 811) argues. And like any object, Leonelli (2015: 811) adds, “they do not have truth-value in and of themselves, nor can they be seen as straightforward representations of given phenomena. Rather, data are essentially fungible objects, which are defined by their portability and their prospective usefulness as evidence.” The tenacity with which these entities can move, black-boxed across generations, demonstrate how standard practices and sources become naturalized and simply common sense (Agarwal, 2012; Geller, 2017; Watkins, 2021).

Walshe was at the cusp of a transition in the enactment of cancers, with statistical data as evidence to make a case. These would displace earlier whole-body, constitutional propensities to explain this disease, shifting to an explanation that increasingly focused on anatomized, pathological parts. In the process, a woman’s breast became a surgical problem for removal (Koblenz, 2013). The status of the surgeon in turn rose above that of the general practitioner (Moscucci, 2005). At the same time, these heroic efforts could not be enacted alone. What made cancer a household word, Koblenz (2013: 7) argues, “was its ability to be discerned under a microscope and treated with a surgical knife.” “Cancer,” therefore, “was a different disease before the medical microscope” (Koblenz 2013: 7). This is not simply a shift in scale that exposed the hidden reality of cancer. Rather, it was becoming something else, altogether.

As for the women at Spring Street, they likely avoided the knife, but quietly bore the shame of their (pre)existing condition. The “socio-medico-religio” cancer complex of the 18^th to mid-19^th century that Koblenz (2013: 7, 17) describes involved not only suffering an amorphous, rare affliction, ⁸ but often doing so in isolation, due to the common notion that it was punishment for sin. Still, the bodies of all three women were interred in the church vaults, suggesting their transgression was no greater than any of the others.

For bioarchaeologists grappling with evidence of cancer at Spring Street, neither skeletal bodies nor historical texts offer soft-tissue masses to palpate. Rather, we are left to contend with loss, the ruins created by proliferating cells in bone and on paper. Traces of cancer, in fact, are more common in the latter, though there may be a person from the vaults who materializes in both. The estimated skeletal age and osteolytic lesions (Biehler-Gomez et al., 2019) in Burial 8 are consistent with a ledger entry for Catherine Rider. A woman by this name died on May 28, 1843, at the age of 64 years, 2 months, and 23 days; her disease was listed as “cancer of the breast.” Cancer in the other three women, however, only appears on paper. But as Mol reminds us, there is no reason that the “truth” of this matter cannot persist alongside that of another.

For the men at Spring Street, one material source seems to pale by comparison. Their cancer only manifests in bone but is absent in the paper form. Given that prostate cancer was not formally named in medical texts until 1853 (Adams, 1853: 393), a case might be made for its lack of use in the common vernacular. Prostate cancer was not some thing some one could have. A body with prostate cancer was not, that is, a way to be or be enacted (Hacking, 2007; Rosenberg, 2006). Unlike a woman’s breast, a man’s prostate was an obscure and difficult organ to treat, though catheters, leeches, warm baths, and enemas might be used to relieve its symptoms (Courtney, 1839: 75–76) (Figure 5). In the burial records, one death is attributed to a “perforated bladder,” suggesting some sort of problem in this area. The decedent was 76-year-old Rudolphus Bogert (1766–1842), one of the few skeletons at Spring Street directly associated with a coffin plate engraved with a name. Importantly, while his skeleton displayed a myriad of other pathological changes, cancerous lesions were not one of them.OPEN IN VIEWER

For the women at Spring Street, their lesions were identified first in bone, followed by four other identifications on paper. Rather than simply additive—this and that—or forcing a choice to be made through opposition—this or that—cancer multiple was enacted with the other. However, for the men in this study, recognition of the skeletal lesions was followed by an “absence” in the ledgers. The temptation would be to devalue the latter for what it lacks. As data, therefore, it is not available to enact. And yet absence, as we have seen, can be informative. Like other “things,” absence does not stand alone, but in relation to that which proceeds it. As long as bone leads—or paper, or pots—and others follow, the stage is set for what might become devalued, missing, or lost. A “present absence,” therefore, has a different texture and meaning than something that was never there to begin with (Fowles, 2010). Thus, to see ontologically is an ethical stance. It involves making choices about who and what to do together—or apart—including the words that make their way into presentations and published papers.

Words otherwise

In this article, I have attempted to slow things down and demonstrate some of the paths I have taken in the process of discovery. In doing so, I have heeded Mol’s (2002: 33) advice for those who set out to study disease: “she stubbornly takes notice of the techniques that make things visible, audible, tangible, knowable. She may talk bodies—but she never forgets about the microscopes.” Rather than a finished product, what I have developed is a sketchbook of cancers multiple from Spring Street and beyond. These sketches are by no means perfect or complete, but open to revision and new paths that might be taken. At the same time, each entry is based on material practices and data that were brought together as evidence to make a case.

But this is not necessarily how others would see it. After I presented a version of this article at a conference, a specialist in paleopathology later pulled me aside to inform me that “we don’t believe it’s cancer, but nice metaphor.” While the “we” remains ambiguous, a peer-review process had occurred over lunch and a decision was made to reject it. Which cancer they were referring to is not entirely clear—whether in bones, radiographs, or archival records. Regardless, the assumption was that they should all point to the same thing, and the data as evidence simply did not add up. As metaphor, however, the cancer(s) I performed were shifted to an alternative space, apart from the scientific form in their ledgers. This was not simply a rhetorical move, but a new separation practice: “language is not something distinct from practices, but it is also done in practices” (Bertoni, 2012: 79, note 8; see also Ingold, 2011: 181–195; Watkins, 2021).

Indeed, writing up is the prized materialization of our studies—the conversion of many enactments into print. The making of such entities, as Gavin Lucas (2019) highlights in Writing the Past, rarely go examined, especially when compared to the attention given to field and laboratory practice. “Objects do not slide silently, untouched, from reality into text,” Mol (2002: 158) adds. Raw data, in this light, has little meaning or value unless activated in a peer-reviewed journal—some thing converted into a rubric of one’s institutional and professional worth. Regardless, these entities persist, filed away in archives, awaiting discovery. Meanwhile, the relevant sources are ordered and arranged through coordination techniques. Tables, graphs, photographs, and text are assembled to make a case. The choice of words is of vital importance.

Standardization is one technique for making multiplicity appear as one. A 2017 issue of the International Journal of Paleopathology (IJPP) devoted to “Scientific Rigor in Paleopathology” outlines guidelines for this process. Standardized terminology, categorical levels of certainty, and differential diagnoses are used to narrowly define and sculpt a scientific product (Buikstra et al., 2017). To punctuate this point, the editors (Buikstra et al., 2017: 83–4) reiterate the advice of two medical doctors (Ragsdale and Lehmer, 2012: 243):

The approach of agreeing on a few experts to set the terms, and then agreeing on common usage in the major journal in the field, will likely help paleopathology, as it has in other fields … With conscientious authors and reviewers working alongside diligent, strong-willed editors, rules will become habits, and manuscripts using uncanonized terminology will go unpublished.

There is no mincing of words in this purification process, which serves to discipline both specialists and the bodies they study.

At the same time, the editors of the IJPP special series emphasize the interdisciplinary nature of good scholarship, which requires researchers to develop a broad knowledge base that draws from the biomedical sciences, social sciences, and humanities. The model they propose for the “synthesis of rigorous scientific and humanistic perspectives” also outlines a strict methodical procedure: “Rooted in scientific method, the program of study becomes decidedly humanistic in the interpretive stages, where careful critical thought, coupled with creativity, is required to generate compelling and robust arguments” (Buikstra et al., 2017: 81). In this model of synthesis, the science/humanity dichotomy remains firmly in place, as do the empirical and interpretive sources they mark. And while these sources as data are allowed to share the page, symmetry is by no means implied. Science leads, others follow.

Here, then, a choice must be made. “Talking about ontologies is inevitably talking about power and politics” (McDonald, 2017: 136). There is always a decision to be made about what to do. If I alter my words and descriptions, using more technical, standardized terms and the rhetorical process of differential diagnosis, might “cancer” materialize before the reviewer’s eyes—perhaps even as a publishable paper? To do so, however, would involve enacting cancer anew, adding another page to my sketchbook. ⁹ At this point, I think I’ll resist the pressure to conform, “to bow down before necessity, including the necessity of either accepting the rules of the game or being excluded from it” (Stengers, 2018: 131). Instead, I’ll simply let things be, while making a case for doing differently.