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The experience of looking at The Sick Rose, which is a good-curated print display of images that are freely available digitally on the Wellcome Images site, raises questions about historical medical images, and when and in what media it's appropriate to look at them. It's one thing to take a beautifully bound book apart into a silent armchair and have a one on one encounter with all the face of an infant wizened by tertiary syphilis, or with a dignified man with a bulbous, untreated pendant tumour. It's another to see the exact same faces flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images and detached from the circumstance of Barnett -supplying scholarship.

Afflictions, most of which are now rare in the Western world organize the Sick Rose: cholera, gout, tuberculosis, advanced phases of syphilis. Online, the patients' anguish runs the danger of being seen as classic"---almost amusing 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 acknowledged to a sense of unease" about sending the pictures off into the world, worrying about 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 pictures 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 advantages of disseminating the fascinating and certainly significant record of the development of medical practice with concerns the images will be misunderstood and misused. Making the images accessible will most likely cause some tone-deaf uses, lacking empathy and regard at best---exploiting the shock value of a disfigured face or body at worst. On the flip side, digitization of the kinds of images which were once accessible only to researchers with the resources to travel to archives can do a lot of good. Such visibility can raise awareness about previous wrongs, ease links between historians and the families of former patients supply us with a new strategy to consider our own mortality. (Because there are excellent arguments on both sides, and because these medical images may be disturbing to some readers, we have decided to set the photos we're printing with this particular article behind a digital scrim, allowing you, the reader, to decide whether to view them.)

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Here's one instance that shows how far such digitized photographs can steal away 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 demanded maxillofacial surgery. Gillies commissioned photographers and artists to document his patients' presurgical harms, using the pictures to plan his team's approach.

These photographs ended up on the Web as a portion of a mid-2000s exhibition 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 graphics 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 website , was intended to learn more about the effect of veterans' wartime injuries and following facial operations on their lives.

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Nevertheless, the digital images had another life after 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. One of the patients in the photographs, Henry Lumley, 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 of postoperative complications, at age 26. (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 wander around in virtual space, made into monsters for the entertainment of gamers.

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Std test closest to Dahlonega. 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 departure in battle as glorious, but facial mutilation was seen as nearly black---a fate worse than death"---and pictures of soldiers injured in this way were censored, lest they decrease morale. So if gamers never understand that the characters they are seeing on screen were once actual men, it can still feel when they're trotted out as digitized monsters, like these guys, ostracized in life, are being wronged again. Dahlonega GA, United States std test. As Wellcome Library archivist Natalie Walters pointed out in a post on the connection between BioShock and also the Gillies Archive: That nearly 100 years after comparable pictures are used to frighten folks in a computer game, gives us a peek into what life must have been like for individuals who sustained such disfiguring injuries." (She adds: How brave these guys were to let themselves to be photographed with extensive injuries, and to experience treatments that often made them seem worse before they looked better.")

Std test closest to Dahlonega. 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 way to take care of 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 using such images in a project like BioShock, where they were disassociated from the names and narratives of the patients, and the Project Faade of Hartley. Std test near me Georgia. I have no issue with all the display of pictures in a historic context, as without this people do not comprehend what war can do."

Should we limit access to upsetting digital images to folks 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 modern medical display, has an argument to the contrary. The NLM's digital groups have lately posted a string of hushed medical movies from between 1929 and 1945 , a few of which symbolize what Sappol calls tough issues": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 movie made at Cook County Hospital in Chicago , which shows four children who are dying of rabies. Fight, 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.

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Sappol does not think it should be the job of the librarian or archivist to decide that the public can't handle looking at images that are such. We are stewards of these historical materials," he told me. They do not belong to us. They belong to everybody. ... I wouldn't like to play on behalf of the subjects and arrogate to myself the job of being some type of policeman of 'who can view.' " With the NLM's electroshock therapy pictures from the 1930s, Sappol says, A Number of the folks in this picture ... look like they surely don't consent to the process, plus it's disturbing to see. I really could say 'This man 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 understand?" The curiosity we feel about such images, he asserts, is not shameful, but only human.

The matter is further complicated by the fact that some subjects prefer visibility. This really is the case with all the Thalidomide Trust archive, which contains 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 happen with their case files vary widely, but some definitely want their files and images made available for research as a willful act to open up discourse."Of course, there's no means to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be viewed or stay hidden. Nevertheless, the modern example of thalidomide demonstrates that we should not assume that publication is tantamount to breach.

Nor should we presume the Web is a less 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 publicly available. Dahlonega, GA 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 photos 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 surgeries.

But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by asking observers to take a second look at the before" images of patients, which Freeman presented for his own goals as broken," she might have the capacity to reveal that these faces include more possibilities than Freeman ever saw." A commenter on Posner's post wrote that he'd recently learned that his grandfather, who he had never met, had been institutionalized and lobotomized in West Virginia. The commenter wrote: I have never seen a picture of my grandfather, never and I really don't care if it is an image of him having this done I merely desire and desire 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 hadn't gone ahead with Science Friday; the link mightn't have been made. Std test near me Dahlonega.

Finally, there's a religious argument for making such images accessible. GA United States std test. Even if medical images may be misused, Michael Sappol says, I do not want that possibility to prevent these things that are really amazing records 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 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 particular point: There is a power behind these pictures, there is a power they have over us, and we have to acknowledge or respect 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, pictures like those in the Sick Rose might remind us: This Is Actually the body, and also the end that we all come to."

Still, a vanitas needs space for contemplation---a space the Web appears 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 photos of suffering could be a memento mori " and serve 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 difficult to come by." One wonders what she might have made of Pinterest if she thought that about television, publications, and art galleries.

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