(Post)colonial scholarship in recent decades has undergone methodological and conceptual revisions and scholars have increasingly adopted the premise that social and political transformations are the product of both global and local struggles. The goal of this paper is to position healthcare as an “imperial force field” by focusing on the development of a colonial healthcare system in the nineteenth-century Danish West Indies. I argue that challenging seemingly self-evident concepts such as healthcare forces us to recognise that interventionist healthcare was contested and negotiated at multiple levels. This paper mobilises archival and archaeological research from a plantation hospital at Estate Cane Garden, St. Croix, Virgin Islands, to provide a context for interrogating the practical negotiations of colonial healthcare policy. While colonial administrative documents and physician reports depict a rather narrow range of healthcare practices, archaeological evidence from a plantation hospital suggests that healthcare, within plantation institutions, was more heterogeneous than the documents indicate. The goal of this paper is largely methodological. It mobilises colonial transcripts and material culture in ways that disrupt and reimagine taken-for-granted assumptions to show how those most affected by colonial policies complicate colonial institutions via on-the-ground practices.