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The experience of looking at The Sick Rose, which is a well-curated print presentation of pictures that are freely available digitally on the Wellcome Images site, raises questions about medical pictures that are historical, and when and in what media it's appropriate to see them. It's one thing to take a beautifully bound book apart into a quiet armchair and have a one-on-one encounter with all with a dignified man with a bulbous, untreated pendant tumor, or the face of an infant wizened by tertiary syphilis. It's another to see exactly the same faces detached from the circumstance of Barnett and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images -supplying scholarship.
The Sick Rose is formed by afflictions, the majority of which are now rare in the Western world: cholera, gout, tuberculosis, advanced stages of syphilis. Online, the patients' anguish runs the danger of being seen as vintage"---almost funny in its horrible extremity and its space from our own time. In a blog post about the process of assembling and later marketing The Sick Rose, Barnett admitted to a sense of unease" about sending the images off into the whole world, worrying regarding the kitsch, knowing, and emptily ironized approach" that could greet the images. (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 pictures of something that happened to someone somewhere. They're not pictured."
As historic medical images go digital, scholars and archivists are being compelled to weigh the advantages of disseminating the interesting and certainly significant record of the progression of medical practice with issues the images will likely be misused and misunderstood. Making the images available will probably cause some tone-deaf uses, lacking empathy and respect at best---using the shock value of a disfigured face or body at On the flip side, digitization of the kinds of images that were once accessible only to researchers with the means to travel to archives can do plenty of good. Such visibility can raise awareness about previous wrongs, ease the families of former patients as well as links between historians supply us with a brand new approach to think of our own mortality. (Because there are excellent arguments on either side, and because these medical images could be upsetting to some readers, we've decided to put the photographs we're printing with this particular post behind an electronic scrim, which allows you, the reader, to decide whether to see them.)
Here's one case that shows how far such digitized photos 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 document his patients' presurgical injuries, using the pictures to plan the strategy of his team.
These photos ended up on the Web as a portion 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 artwork that Hartley made from these archives with inspiration later formed the foundation of an exhibition at London's National Army Museum. The project, Hartley writes on his web site , was intended to learn more about the effect of veterans' wartime injuries and following facial surgeries on their lives.
Following the exhibit had closed, but the digital images had another life. Some pictures from the Endeavor Faade archive ended up used in the plan of the genetic mutants (splicers") that players of the videogame BioShock must battle. Henry Lumley, one of the patients in the photographs, a pilot trainee, lived with his injury for a year and was injured on the day of his graduation from flying school before being admitted to Gillies' attention. Lumley died of postoperative complications, at age 26. (Here's his page on the Project Faade website And here's an image of the BioShock character in question) Lumley and his fellow patients are now compelled to drift about in virtual space, made into monsters for the entertainment of gamers.
Std test nearest Tununak. Does this issue, given that many (most?) BioShock players WOn't ever understand who these men were in real life? Biernoff writes that British culture during the World War I perceived death in battle as glorious, but facial mutilation was seen as almost black---a fate worse than death"---and images of soldiers injured in this manner were censored, lest they diminish morale. So even if gamers never realize that the characters they're seeing on screen were once real guys, it can still feel like these guys, ostracized in life, are being wronged again when they are trotted out as digitized monsters. Tununak, AK, United States Std Test. As Wellcome Library archivist Natalie Walters pointed out in a post on the connection between BioShock as well as the Gillies Archive: That nearly 100 years later similar pictures are used to frighten people in a computer game, gives us a glimpse into what life must have been like for people who sustained such disfiguring injuries." (She includes: How courageous these men were to let themselves to be photographed with extensive injuries, and to undergo treatments that frequently made them seem worse before they appeared better.")
Std Test near Tununak. Dr. Andrew Bamji, the Gillies Archives' curator, told me over e-mail 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 guys in the context of the game was an appalling approach to treat the memory of veterans," Bamji wrote. He apologized and assured me that no further such images would be utilized, and there the matter finished." Bamji drew a clear distinction between the utilization of such images 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 near Alaska. I don't have any issue with the display of pictures in a historical context, as without this folks do not understand what war can do."
Should we confine access to upsetting digital images to people who we can be sure will see them in appropriate context? Michael Sappol , a historian at the U.S. National Library of Medicine who has written about historic and modern medical display, has an argument to the contrary. The NLM's digital groups have recently posted a string of silent medical films from between 1929 and 1945 , some of which represent what Sappol calls difficult subjects": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 picture made at Cook County Hospital in Chicago , which shows four kids who 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 pictures that are such. We're stewards of these historical materials," he told me. They don't belong to us. They belong to everybody. ... I would not like to play on behalf of the subjects and arrogate to myself the occupation of being some type of officer of 'who can view.' " With the NLM's electroshock therapy films from the 1930s, Sappol says, Some of the people in this film ... seem like they definitely do not consent to the procedure, also it's disturbing to see. I could say 'This individual doesn't 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 curiosity we feel about such pictures, he contends, isn't shameful, but only human.
The matter is further complicated by the fact that visibility is preferred by some subjects. This is the situation with all the Thalidomide Trust archive, which features medical case files on folks 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 views of thalidomiders themselves on what should happen with their case files fluctuate widely, but some definitely need their files and images made accessible for research as a deliberate act to open up disagreement."Of course, there's no means to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be seen or remain hidden. But the modern example of thalidomide reveals that we shouldn't assume that publication is tantamount to breach.
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 also a digital historian committed to making her sources freely accessible. Tununak, AK std test. In 2010, Posner posted about the ethical quandary she faced when requested to collaborate with a producer at NPR's show Science Friday on a slideshow of photos that were lobotomy. Neurologist Walter Freeman, who carried out more than 3,500 of the processes, photographed and filmed his patients before and after their operations.
But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by asking audiences to take a second look at the before" images 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 Posner's place wrote that he'd lately learned that his grandfather, lobotomized and who he had never met, had been institutionalized in West Virginia. The commenter wrote: I have not seen a picture of my grandpa, never and I do not care if it is a picture of him having this done I need and merely want to see a picture of him so MUCH. Can you tell me the best way to get to these archives?" It might have been much more difficult for the commenter to locate her if Posner had not gone with Science Friday; the link might not have been made. Std test near Tununak.
Eventually, there is a spiritual argument for making such images accessible. AK, United States Std Test. Even if medical images may be abused, Michael Sappol says, I don't desire that possibility to prevent these things that are really amazing files of the human experience from being seen. ... We can learn from them, they are able to redeem us in some way. They are able to supply us with some type of program of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, concurs on this particular point: There's a power behind these pictures, there's a power they have over us, and we've got to accept 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, images like those in the Sick Rose might remind us: This is the body, as well as the conclusion that we all come to."
Still, a vanitas demands space for contemplation---a space the Web appears ill prepared to offer. Susan Sontag's closing book, Regarding the Pain of Others (2003), was composed as the Web was in the procedure for scattering photos to the four winds. Sontag wrote that photos of suffering might be a memento mori " and serve 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 reserved for being serious is challenging to come by." One wonders what she might have made of Pinterest if she believed that about television, books, and art galleries.
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