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The experience of looking at The Sick Rose, which is a good-curated print presentation of pictures that are accessible digitally on the Wellcome Images site, raises questions about medical pictures that are historical, and when and in what media it's appropriate to look at them. It is one thing to take a beautifully bound book apart into a quiet armchair and have a one on one encounter with with a dignified man with a bulbous, untreated pendant tumor, or the face of an infant wizened by tertiary syphilis. It is another to see exactly the same faces detached from the context of Barnett and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated pictures -supplying scholarship.
The Sick Rose is formed by afflictions, the majority of which are now rare in the Western world: cholera, tuberculosis, gout, advanced stages of syphilis. Online, the patients' suffering runs the risk of being seen as classic"---almost amusing in its dreadful extremity and its distance from our own time. In a blog post about the method of assembling and later promoting The Sick Rose, Barnett admitted to a feeling of unease" about sending the pictures off into the whole world, worrying regarding the kitsch, understanding, and emptily ironized attitude" 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 images of something that occurred to someone somewhere. They're not envisioned."
As historical medical pictures go archivists, scholars and digital are being compelled to consider the benefits of disseminating the unquestionably important and fascinating record of the evolution of medical practice with concerns the images will likely be misunderstood and misused. Making the images accessible will most likely lead to some tone-deaf uses, lacking empathy and regard at best---using the shock value of an at body disfigured face or On the other hand, digitization of the types of pictures which were once available 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 connections between historians and also the families of former patients , even provide us with a fresh way 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've decided to put the photographs we're printing with this particular article behind an electronic scrim, which allows you, the reader, to decide whether to view them.)
Here's one instance that shows how much such digitized photographs can slip from their circumstances. 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 component treating injuries that required maxillofacial surgery. Gillies commissioned artists and photographers to document his patients' presurgical harms, using the pictures to plan his team's strategy.
These photos ended up on the Web as a portion of a mid-2000s exhibit titled Project Faade (now archived via the Wayback Machine ). The job, which was financed 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 graphics that Hartley made with inspiration from these archives after formed the basis of an exhibit at the National Army Museum in London. The project, Hartley writes on his website , was intended to explore the impact of veterans' wartime injuries and following facial surgeries on their lives.
But the digital images had another life following the exhibition had closed. Some photos from the Endeavor Faade archive ended up used in the design of the genetic mutants (splicers") that players of the videogame BioShock must battle. Henry Lumley, one of many patients in the pictures, a pilot trainee, was injured on the day of his graduation from flying school and lived with his injury for a year 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 compelled to wander about in virtual space, made into monsters for the amusement of gamers.
Std Test in Reseda. Does this matter, given that many (most?) BioShock players will never 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 pictures of soldiers injured in this way were censored, lest they decrease morale. So even if gamers never realize that the characters they're seeing on screen were once real guys, it can still feel when they are trotted out as digitized monsters, like these men, ostracized in life, are being wronged again. Reseda, CA, 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 almost 100 years later similar pictures are used to frighten people in a computer game, gives us a glance into what life must have been like for individuals who endured such disfiguring injuries." (She includes: How courageous these guys were to allow themselves to be photographed with extensive injuries, and to undergo treatments that often made them seem worse before they looked better.")
Std Test nearby Reseda. 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 use of identifiable men in the circumstance of the game was an appalling method to take care of the memory of veterans," Bamji wrote. He apologized and assured me that no further such images would be used, and there the matter finished." Bamji drew a clear distinction between the utilization of such images in a project like BioShock, where they were disassociated from the names and stories of the patients, and Hartley's Project Faade. Std Test closest to California. I have no problem with the display of images in a historic context, as without this people don't comprehend what war can do."
Should we restrict access to upsetting digital images to folks who we can be certain will perceive them in proper context? Michael Sappol , a historian at the U.S. National Library of Medicine who has written about historical and contemporary medical display, has an argument to the contrary. The NLM's digital groups have recently posted a run of hushed medical films 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 children who are dying of rabies. Struggle, the patients convulse, bleed from the mouth; they are inconsolable, even as gloved adult hands reach from off screen to hold them or offer them water.
Sappol does not believe it should be the occupation of the librarian or archivist to decide that the public can't handle looking at such pictures. We are stewards of these historical materials," he told me. They don't 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 kind of cop of 'who can view.' " With the NLM's electroshock therapy films from the 1930s, Sappol says, A Number of the people in this film ... appear like they surely don't consent to the procedure, also it is upsetting to see. I really could say 'This person does not need to be on camera, they are being humiliated.' But this is something we can learn from. If we never get to see this, who gets to know?" The interest we feel about such pictures, he asserts, isn't black, but only human.
The issue is further complicated by the fact that visibility is preferred by some subjects. This really is the situation with all the Thalidomide Trust archive, which contains medical case files on folks born withsevere birth defects after their mothers took the drug thalidomide to alleviate symptoms of morning sickness in the late 1950s-early-1960s," Wellcome archivist Helen Wakely wrote to me. The perspectives of thalidomiders themselves on what should occur with their case files fluctuate widely, but some undoubtedly want their files and pictures made available for research as a willful act to open up debate."Of course, there's no method to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be seen or remain hidden. Nevertheless, the modern example of thalidomide reveals that we should not presume that publication is tantamount to breach.
Nor should we presume that the Web is a serious medium than the bound-and- printed book. Historian Miriam Posner, who wrote her dissertation on medical filmmaking, is additionally a digital historian dedicated to making her sources freely accessible. Reseda, CA 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 pictures that were lobotomy. Neurologist Walter Freeman, who carried out more than 3,500 of the procedures, photographed and patients his filmed before and after their operations.
But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by asking viewers to take a second look at the before" images of patients, which Freeman presented for his own motives as broken," she might have the ability to show that these faces feature more options than Freeman ever saw." A commenter on Posner's post wrote that he'd recently discovered that his grandpa, who he'd never met, had been institutionalized and lobotomized in West Virginia. The commenter wrote: I have not seen an image of my grandpa, never, ever, and I don't care if it's a graphic of him having this done I desire and merely desire to see a picture of him so MUCH. Can you tell me how to get to these archives?" It might have been much harder for the commenter to find her if Posner hadn't gone with Science Friday; the link might not have been made. Std Test nearest Reseda.
Eventually, there is a religious argument for making such images accessible. CA United States Std Test. Even if medical pictures might be misused, Michael Sappol says, I don't want that chance to prevent these things that are really amazing documents of the human encounter from being seen. ... We can learn from them, they can redeem us in some way. They could provide us with some type of curriculum of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, agrees on this point: There is a power behind these images, there is a power they have over us, and we've got to recognize or respect this at some point." He compares the images 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 the body, along with the conclusion that we all come to."
Still, a vanitas demands space for contemplation---a space the Web seems ill to offer. Susan Sontag's closing book, Regarding the Pain of Others (2003), was composed as the Web was in the procedure for scattering photographs to the four winds. Sontag wrote that photographs of suffering might be a memento mori " and function as a still point around which to contemplate mortality. But she wondered how this might function---or fail to work---in a modern society," where space allowed for being serious is tough to come by." If she thought that about art galleries, books, and television, one wonders what she might have made of Pinterest.
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