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The experience of looking at The Sick Rose, which is a good-curated print presentation of pictures that are available digitally on the Wellcome Images site, raises questions about medical pictures that are historical, and when and in what media it is proper to look at them. It is one thing to take a beautifully bound book aside into a silent armchair and have a one-on-one encounter with with a dignified man with a bulbous, untreated pendant tumour, or the face of a baby wizened by tertiary syphilis. It is another to see the exact same faces detached from the circumstance 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: gout, cholera, tuberculosis, advanced phases of syphilis. Online, the patients' anguish runs the risk of being seen as vintage"---almost amusing in its terrible extremity and its distance from our own time. In a blog post about the method of assembling and later marketing The Sick Rose, Barnett admitted to a feeling of unease" about sending the images away into the entire world, worrying concerning the kitsch, knowing, and emptily ironized attitude" that could greet the pictures. (When Wired ran a slideshow of photographs 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 occurred to someone somewhere. They're not imagined."
As historic medical pictures go archivists, scholars and digital are being forced to consider the benefits of disseminating the definitely important and fascinating record of the development of medical practice with concerns that the pictures will probably be misunderstood and misused. Making the images available will probably result in some tone-deaf uses and respect at best---exploiting the shock value of an at body disfigured face or worst. On the other hand, digitization of the kinds of pictures which were once available only to researchers with the means to travel to archives can do a great deal of good. Such visibility can raise awareness about previous wrongs, facilitate links between historians and the families of former patients , even provide us with a new approach to think of our own mortality. (Because there are good arguments on both sides, and because these medical images can be disturbing to some readers, we have chosen to put the pictures we are printing with this particular article behind a digital scrim, allowing you, the reader, to choose whether to view them.)
Here's one instance that shows how far such digitized pictures can steal away from their circumstances. Art historian Suzannah Biernoff has written about the destiny of a group of patient images 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 needed maxillofacial surgery. Gillies commissioned artists and photographers to document his patients' presurgical injuries, using the images to plan his team's approach.
These photographs ended up on the Web as part of a mid-2000s exhibition titled Project Faade (now archived via the Wayback Machine ). The job, which was funded by the Wellcome Trust's SciArt Production Award, was a collaboration 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 graphics that Hartley made with inspiration from these archives later formed the foundation of an exhibit at the National Army Museum in London. The project, Hartley writes on his site , was meant to learn more about the effect of veterans' wartime injuries and subsequent facial operations on their lives.
Following the exhibition had closed, but the digital images had another life. Some photographs from the Project Faade archive ended up used in the plan of the genetic mutants (splicers") that players of the videogame BioShock must battle. One of the patients in the pictures, a pilot trainee, Henry Lumley, was injured on the day of his graduation from flying school and lived with his harm for a year before being admitted to Gillies' care. Lumley died at age 26, of postoperative complications. (Here's his page on the Project Faade site And here's an image of the BioShock character in question) Lumley and his fellow patients are now forced to wander about in virtual space, made into monsters for the entertainment of gamers.
Std Test nearest Payson. Does this matter, given that many (most?) BioShock players will never 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 manner were censored, lest they diminish morale. So if gamers never understand that the characters they're seeing on screen were once real guys, it can nevertheless feel when they are trotted out as digitized monsters like these men, ostracized in life, are being wronged again. Payson, AZ, 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 comparable images are used to frighten folks in a computer game, gives us a peek into what life must have been like for people who endured such disfiguring injuries." (She includes: How courageous these men were to let themselves to be photographed with extensive injuries, and to undergo treatments that often made them look worse before they appeared better.")
Std test nearest Payson. Dr. Andrew Bamji, the Gillies Archives' curator, told me over e-mail that he approached the game's programmers after finding out about this use and succeeded in contacting one. I pointed out that the use of identifiable men in the circumstance of the game was an appalling way to take care of the memory of veterans," Bamji wrote. He apologized and assured me that no additional such images would be utilized, and there the matter finished." Where they were disassociated from the names and narratives of the patients, and Hartley's Project Faade Bamji drew a clear distinction between using such pictures in a job like BioShock. Std test nearest Arizona. I have no problem with all the display of images in a historic context, as without this folks don't understand what war can do."
Should we restrict access to upsetting digital images to folks who we can be certain 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 lately posted a string of quiet medical pictures from between 1929 and 1945 , some of which represent what Sappol calls hard issues": 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're inconsolable, even as gloved adult hands reach from off screen to hold them or offer them water.
Sappol doesn't think it should be the job of the librarian or archivist to decide that the people can not handle looking at such images. We're stewards of these historical materials," he told me. They do not belong to us. They belong to everybody. ... I wouldn't like to act 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 pictures from the 1930s, Sappol says, A Number of the men and women in this picture ... seem like they definitely do not consent to the procedure, plus it's disturbing to see. I could say 'This individual doesn't desire 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 pictures, he claims, is not black, but simply human.
The problem is further complicated by the fact that a few subjects favor visibility. This is actually the situation with all the Thalidomide Trust archive, which includes medical case files on folks born 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 occur with their case files fluctuate widely, but some undoubtedly need their files and images made accessible for research as a purposeful action to open up disagreement."Of course, there is not any way to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be viewed or remain hidden. But the modern example of thalidomide shows that we should not presume that publication is tantamount to breach.
Nor should we suppose the Web is a less serious medium than the bound-and- printed book. Historian Miriam Posner, who wrote her dissertation on medical filmmaking, is also a digital historian committed to making her sources publicly available. Payson AZ 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 pictures that were lobotomy. 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 ultimately went ahead with the Science Friday slideshow, reasoning that by simply asking viewers to choose a second look at the before" pictures of patients, which Freeman presented for his own goals as broken," she may manage to show that these faces contain more possibilities than Freeman ever saw." A commenter on Posner's place wrote that he'd lately discovered that his grandpa, lobotomized and who he had never met, had been institutionalized in West Virginia, where Freeman did some of his work. The commenter wrote: I don't care if it's an image of him having this done I merely want and desire to see a picture of him so MUCH, and I haven't seen an image of my grandfather, never, ever. Can you tell me the way to get to these archives?" It might have been much tougher for the commenter to locate her, if Posner had not gone with Science Friday; the link mightn't have been made. Std test near Payson.
Finally, there is a spiritual argument for making such pictures available. AZ, United States std test. Even if medical pictures might be misused, Michael Sappol says, I don't want that possibility to prevent these things that are actually amazing documents of the human experience from being seen. ... We can learn from them, they could redeem us in some way. They could provide us with some sort of curriculum of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, concurs on this point: There's a power behind these images, there is a power they have over us, and we have to acknowledge or honor this at some point." He compares the pictures to a secular 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, along with the end that we all come to."
Still, a vanitas demands space for contemplation---a space the Web seems ill prepared to offer. Susan Sontag's final book, Regarding the Pain of Others (2003), was composed as the Web was in the procedure for scattering pictures to the four winds. Sontag wrote that pictures of suffering might be a memento mori " and serve as a still point around which to contemplate mortality. But she wondered how this might work---or fail to work---in a modern society," where space reserved for being serious is tough to come by." If she believed that about art galleries, books, and television, one wonders what she might have made of Pinterest.
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