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The experience of looking at The Sick Rose, which is a well-curated print display of images that are accessible digitally on the Wellcome Images site, raises questions about medical pictures that are historic, and when and in what media it is proper to look at them. It's one thing to take a beautifully bound book aside into a quiet armchair and have a one on one encounter with all the face of a baby wizened by tertiary syphilis, or with a dignified man with a bulbous, untreated pendant tumor. It is another to see the same faces detached from the context of Barnett and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated pictures -providing scholarship.
The Sick Rose is formed by afflictions, most of which are now rare in the Western world: cholera, gout, tuberculosis, advanced phases of syphilis. On the Internet, the patients' suffering runs the danger of being seen as vintage"---nearly amusing in its horrible extremity and its space from our own time. In a blog post about the method of assembling and later promoting The Sick Rose, Barnett acknowledged to a sense of unease" about sending the images away into the planet, worrying about the kitsch, understanding, and emptily ironized approach" that could greet the pictures. (When Wired ran a slideshow of pictures from Sick Rose in May, for instance, it was headlined Awesomely Gross Medical Illustrations From the 19th Century") Over Skype, Barnett told me: These are all images of something that happened to someone somewhere. They're not pictured."
As historical medical images go archivists, scholars and digital are being compelled to consider the benefits of disseminating the definitely important and fascinating record of the progression of medical practice with matters the images will likely be misused and misunderstood. Making the images accessible will probably cause some tone-deaf uses and aspect at best---manipulating the shock value of a disfigured face or body at worst. On the flip side, digitization of the sorts of pictures which were once accessible only to researchers with the resources to travel to archives can do a great deal of great. Such visibility can raise consciousness about previous wrongs, ease the families of former patients and links between historians , even provide us with a brand new method to consider our own mortality. (Because there are good arguments on both sides, and because these medical images could be disturbing to some readers, we have decided to set the photos we're printing with this specific article behind a digital scrim, allowing you, the reader, to decide whether to view them.)
Here's one instance that shows how much such digitized photographs can steal from their contexts. Art historian Suzannah Biernoff has written about the destiny of a group of patient pictures from the Gillies Archives These are the World War I-era records of Queen Mary's Hospital, Sidcup, in the U.K., where plastic surgeon Harold Gillies headed a special unit treating injuries that demanded maxillofacial surgery. Gillies commissioned photographers and artists to record his patients' presurgical injuries, using the images to plan the strategy of his team.
These photos ended up on the Web as part of a mid-2000s exhibit titled Project Faade (now archived through the Wayback Machine ). The job, which was funded by the Wellcome Trust's SciArt Production Award, was a cooperation among artist Paddy Hartley; Dr. Andrew Bamji, a rheumatologist who acts as curator of the Gillies Archives; and Dr. Ian Thompson, a surgeon and designer of facial implants. The visuals that Hartley made from these archives with inspiration afterwards formed the foundation of an exhibition at London's National Army Museum. The project, Hartley writes on his site , was meant to explore the impact of veterans' wartime injuries and subsequent facial surgeries on their lives.
But the digital images had another life after the exhibit had closed. Some photographs from the Endeavor Faade archive ended up used in the plan of the genetic mutants (splicers") that players of the videogame BioShock must battle. Among the patients in the photos, Henry Lumley, a pilot trainee, lived with his harm for a year and was injured on the day of his graduation from flying school before being declared to Gillies' attention. Lumley died at age 26, of postoperative complications. (Here's his page on the Project Faade site And here's a picture of the BioShock character in question) Lumley and his fellow patients are now forced to drift about in virtual space, made into monsters for the amusement of gamers.
Std Test in Guntersville. Does this issue, given that many (most?) BioShock players WOn't ever know who these men were in real life? Biernoff writes that British culture during the World War I perceived departure in battle as glorious, but facial mutilation was seen as virtually black---a fate worse than death"---and pictures of soldiers injured in this way were censored, lest they reduce morale. So if gamers never realize that the characters they are seeing on screen were once real guys, it can nevertheless feel like these guys, ostracized in life, are being wronged again when they're trotted out as digitized monsters. Guntersville AL, United States Std Test. As Wellcome Library archivist Natalie Walters pointed out in a post on the connection between BioShock along with the Gillies Archive: That almost 100 years after similar pictures are used to frighten people in a computer game, gives us a glimpse into what life should have been like for folks who endured such disfiguring injuries." (She includes: How courageous these guys were to enable themselves to be photographed with extensive injuries, and to get treatments that often made them seem worse before they appeared better.")
Std test near Guntersville. Dr. Andrew Bamji, the Gillies Archives' curator, told me over email that he approached the game's developers after finding out about this use and succeeded in contacting one. I pointed out that the usage of identifiable men in the context of the game was an appalling approach to take care of the memory of veterans," Bamji wrote. He apologized and assured me that no additional such pictures would be utilized, and there the matter ended." Bamji drew a clear distinction between the usage of such pictures in a job like BioShock, where they were disassociated from the names and narratives of the patients, and the Project Faade of Hartley. Std test nearby Alabama. I have no issue with the display of images in a historical context, as without this folks do not comprehend what war can do."
Should we limit accessibility to upsetting digital images to individuals who we can be sure will see them in proper context? Michael Sappol , a historian at the U.S. National Library of Medicine who has written about historical and modern medical display, has an argument to the contrary. The NLM's digital groups have lately posted a string of quiet medical pictures from between 1929 and 1945 , a few of which signify what Sappol calls challenging subjects": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 picture made at Cook County Hospital in Chicago , which shows four kids that are dying of rabies. The patients convulse, struggle, bleed from the mouth; they are inconsolable, even as gloved adult hands reach from off screen to hold them or offer them water.
Sappol doesn't believe it should be the occupation of the librarian or archivist to decide that the public can not handle looking at such images. We're stewards of these historical materials," he told me. They don't belong to us. They belong to everybody. ... I wouldn't like to play on behalf of the areas and arrogate to myself the job of being some sort of officer of 'who can view.' " With the NLM's electroshock therapy pictures from the 1930s, Sappol says, A Number of the people in this movie ... seem like they surely do not consent to the procedure, and it's disturbing to see. I really could say 'This individual does not need to be on camera, they're being humiliated.' But this is from. If we never get to see this, who gets to know?" The fascination we feel about such images, he claims, isn't black, but just human.
The issue is further complicated by the fact that some subjects favor visibility. This is the case with all the Thalidomide Trust archive, which includes medical case files on individuals produced withsevere birth defects after their mothers took the drug thalidomide to ease symptoms of morning sickness in the late 1950s-early-1960s," Wellcome archivist Helen Wakely wrote to me. The viewpoints of thalidomiders themselves on what should happen with their case files vary widely, but some undoubtedly want their files and images made accessible for research as a willful action to open up discussion."Of course, there's no way to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be viewed or stay hidden. Nevertheless, the modern case of thalidomide shows that we must not suppose that publication is tantamount to infringement.
Nor should we presume that the Web is a serious medium than the bound-and- book that is printed. Historian Miriam Posner, who wrote her dissertation on medical filmmaking, is additionally a digital historian dedicated to making her sources freely available. Guntersville, AL Std Test. In 2010, Posner posted about the ethical quandary she faced when asked to collaborate with a producer at NPR's show Science Friday on a slideshow of lobotomy photos. Neurologist Walter Freeman, who carried out more than 3,500 of the procedures, photographed and filmed his patients before and after their surgeries.
But Posner finally went ahead with the Science Friday slideshow, reasoning that by asking audiences to take a second look at the before" pictures of patients, which Freeman presented for his own goals as broken," she may have the capacity to reveal that these faces contain more possibilities than Freeman ever saw." A commenter on the post of Posner wrote that he had recently discovered that his grandfather, lobotomized and who he'd never met, had been institutionalized in West Virginia, where Freeman did some of his work. The commenter wrote: I have never seen a picture of my grandfather, never and I do not care if it's an image of him having this done I need and only desire to see a picture of him so MUCH. Can you tell me how to get to these archives?" It might have been considerably more challenging for the commenter to locate her, if Posner hadn't gone with Science Friday; the connection might not have been made. Std Test near Guntersville.
Finally, there is a religious argument for making such images accessible. AL, United States std test. Even if medical images might be abused, Michael Sappol says, I do not desire that chance to prevent these things that are really amazing records of the human encounter from being seen. ... We can learn from them, they could redeem us in some way. They can provide us with some kind of program of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, concurs on this particular point: There is a power behind these images, there is a power they have over us, and we've got to acknowledge or honor this at some point." He compares the pictures to a lay vanitas ," referring to the 17th century Dutch paintings of skulls and other symbols of decay that were meant to remind the viewer of human mortality. For modern viewers, Barnett says, pictures like those in the Sick Rose might remind us: This Is Actually the body, and the end that we all come to."
Still, a vanitas demands space for contemplation---a space the Web looks ill to offer. Susan Sontag's final book, Regarding the Pain of Others (2003), was written as the Web was in the procedure for scattering photos to the four winds. Sontag wrote that pictures of suffering could be a memento mori " and function as a still point around which to contemplate mortality. But she wondered how this could work---or fail to work---in a modern society," where space allowed for being serious is difficult to come by." One wonders what she may have made of Pinterest if she thought that about television, books, and art galleries.
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