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The experience of looking at The Sick Rose, which is a good-curated print display of images that are available digitally on the Wellcome Images site, raises questions about historical medical pictures, and when and in what media it is proper to see them. It is one thing to take a beautifully bound book aside 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'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 -providing scholarship.

Afflictions, most of which are now rare in the Western world organize the Sick Rose: gout, cholera, tuberculosis, advanced stages of syphilis. On the Internet, the patients' suffering runs the risk of being seen as vintage"---almost comical in its horrible extremity and its space from our own time. In a blog post about the process of assembling and after promoting The Sick Rose, Barnett acknowledged to a sense of unease" about sending the pictures away into the planet, worrying concerning the kitsch, knowing, and emptily ironized approach" that could greet the images. (When Wired ran a slideshow of photos from Sick Rose in May, for example, 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 visualized."

As historical medical images go digital, scholars and archivists are being forced to consider the advantages of disseminating the interesting and definitely important record of the progression of medical practice with issues the images will likely be misunderstood and misused. Making the pictures accessible will probably result in some tone-deaf uses, lacking empathy and aspect at best---exploiting the shock value of a disfigured face or body at On the other hand, digitization of the sorts of pictures which were once available only to researchers with the means to travel to archives can do plenty of good. Such visibility can raise awareness about previous wrongs, ease connections between historians as well as the families of former patients , even provide us with a fresh strategy to think about our own mortality. (Because there are good arguments on either side, and because these medical images may be upsetting to some readers, we've decided to put the photographs we are printing with this specific post behind an electronic scrim, which allows you, the reader, to decide whether to view them.)

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Here's one case that demonstrates how much such digitized pictures can slip away from their contexts. Art historian Suzannah Biernoff has written about the fate 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 required maxillofacial surgery. Gillies commissioned photographers and artists to document his patients' presurgical harms, using the images to plan his team's approach.

These photographs ended up on the Web as part of a mid-2000s exhibit titled Project Faade (now archived via 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 after formed the basis of an exhibit at London's National Army Museum. The project, Hartley writes on his website , was intended to explore the effect of veterans' wartime injuries and following facial surgeries on their lives.

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After the exhibit had closed but the digital images had another life. Some photographs 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 the patients in the pictures, a pilot trainee, was injured on the day of his graduation from flying school and lived with his harm for a year before being admitted to Gillies' attention. Lumley died at age 26, of postoperative complications. (Here's his page on the Project Faade website 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 entertainment of gamers.

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Std test near me Santa Paula. 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 death in battle as glorious, but facial mutilation was seen as almost shameful---a fate worse than death"---and images of soldiers injured in this way were censored, lest they diminish morale. So even if gamers never realize the characters they are seeing on screen were once real guys, it can still feel when they're trotted out as digitized monsters, like these guys, ostracized in life, are being wronged again. Santa Paula, 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 after similar pictures are used to frighten folks in a computer game, gives us a glimpse into what life must have been like for folks who endured such disfiguring injuries." (She includes: How brave these guys were to allow themselves to be photographed with extensive injuries, and to get treatments that frequently made them look worse before they looked better.")

Std Test near Santa Paula. 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 using identifiable guys in the context of the game was an appalling method 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 ended." Where they were disassociated from the names and stories of the patients, and Hartley's Project Faade Bamji drew a clear distinction between the use of such pictures in a project like BioShock. Std test nearby California. I don't have any problem with the display of images in a historic context, as without this people don't comprehend what war can do."

Should we limit accessibility to upsetting digital images to individuals who we can be certain will perceive them in appropriate 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 string of silent medical movies from between 1929 and 1945 , some of which symbolize what Sappol calls challenging issues": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 movie made at Cook County Hospital in Chicago , which shows four kids that are dying of rabies. The patients convulse, fight, bleed from the mouth; they're inconsolable, even as offer them water or gloved adult hands reach from off screen to hold them.

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Sappol doesn't think it should be the job of the librarian or archivist to determine that the people can't handle looking at images 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 job of being some sort of cop of 'who can view.' " With the NLM's electroshock therapy films from the 1930s, Sappol says, Some of the people in this movie ... appear like they certainly do not consent to the procedure, also it is upsetting to see. I really could say 'This man does not desire to be on camera, they're being humiliated.' But this is something we can learn from. If we never get to see this, who gets to understand?" The fascination we feel about such pictures, he claims, is not shameful, but simply human.

The matter is further complicated by the fact that visibility is preferred by some subjects. This is actually the situation with all the Thalidomide Trust archive, which includes medical case files on people 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 occur with their case files vary widely, but some definitely want their files and pictures made accessible for research as a purposeful action to open up discussion."Of course, there's not any means to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be observed or remain hidden. Nevertheless, the modern case of thalidomide reveals that we must not suppose that publication is tantamount to breach.

Nor should we suppose that 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 dedicated to making her sources freely accessible. Santa Paula, 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 photographs that were lobotomy. Neurologist Walter Freeman, who carried out more than 3,500 of the processes, photographed and patients his filmed before and after their operations.

But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by simply asking audiences to choose a second look at the before" images of patients, which Freeman presented for his own purposes as broken," she might manage to show that these faces comprise more possibilities than Freeman ever saw." A commenter on Posner's post wrote that he'd lately learned that his grandpa, lobotomized and who he had never met, had been institutionalized in West Virginia. The commenter wrote: I actually don't care if it is a picture of him having this done I just want and need to see a picture of him so MUCH, and I have never seen an image of my grandpa, never, ever. Can you tell me the best way to get to these archives?" It might have been considerably more difficult for the commenter to find her, if Posner hadn't gone with Science Friday; the link might not have been made. Std Test closest to Santa Paula.

Finally, there's a religious argument for making such images accessible. CA, United States std test. Even if medical pictures may be misused, Michael Sappol says, I do not want that chance to prevent these things that are really amazing files of the human experience from being seen. ... We can learn from them, they could redeem us in some way. They are able to supply us with some kind of program 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 pictures, there is a power they have over us, and we've got to acknowledge or honor this at some point." He compares the images 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, pictures like those in the Sick Rose might remind us: This Is Actually the body, and the conclusion that we all come to."

However, a vanitas requires space for contemplation---a space the Web looks ill prepared to offer. Susan Sontag's final book, Regarding the Pain of Others (2003), was composed as the Web was in the process of 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 could function---or fail to work---in a modern society," where space allowed for being serious is hard to come by." If she thought that about art galleries, novels, and television, one wonders what she might have made of Pinterest.

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