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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 historic 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 aside into a quiet 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 tumor. It's another to see 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.

Afflictions, the majority 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 risk of being seen as vintage"---almost comical in its awful extremity and its distance from our own time. In a blog post about the procedure for assembling and after promoting The Sick Rose, Barnett acknowledged to a feeling of unease" about sending the pictures off into the entire world, worrying about the kitsch, understanding, and emptily ironized attitude" that could greet the images. (When Wired ran a slideshow of photographs 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 pictures of something that occurred to someone somewhere. They're not visualized."

As historical medical pictures go digital, scholars and archivists are being forced to weigh the benefits of disseminating the certainly significant and fascinating record of the development of medical practice with concerns that the pictures will probably be misused and misunderstood. Making the pictures accessible will probably cause some tone deaf uses and regard at best---exploiting the shock value of an at body disfigured face or worst. On the other hand, digitization of the sorts of images which were once available only to researchers with the resources to travel to archives can do plenty of good. Such visibility can raise awareness about past wrongs, ease the families of former patients and connections between historians supply us with a fresh approach to think of our own mortality. (Because there are great arguments on both sides, and because these medical images may be disturbing to some readers, we've chosen to place the photographs we are printing with this particular post behind a digital scrim, allowing you, the reader, to decide whether to see them.)

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Here's one instance that demonstrates how far such digitized photos can steal away 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 specific component treating injuries that demanded maxillofacial surgery. Gillies commissioned artists and photographers to document his patients' presurgical injuries, using the images to plan the approach of his team.

These pictures ended up on the Web as part of a mid-2000s exhibition titled Project Faade (now archived through the Wayback Machine ). The job, which was financed 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 art that Hartley made with inspiration from these archives later formed the foundation of an exhibition at the National Army Museum in London. The endeavor, Hartley writes on his web site , was intended to explore the effect of veterans' wartime injuries and subsequent facial surgeries on their lives.

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After the exhibition had closed nevertheless, the digital images had another life. Some photos from the Project Faade archive ended up used in the plan of the genetic mutants (splicers") that players of the videogame BioShock must battle. Among the patients in the pictures, a pilot trainee, Henry Lumley, lived with his injury for a year and was injured on the day of his graduation from flying school before being admitted to Gillies' care. 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 wander around in virtual space, made into monsters for the entertainment of gamers.

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Std Test nearest Abingdon. Does this issue, 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 shameful---a fate worse than death"---and images of soldiers injured in this manner were censored, lest they reduce morale. So if gamers never understand that the characters they're seeing on screen were once actual guys, it can still feel like these men, ostracized in life, are being wronged again when they are trotted out as digitized monsters. Abingdon, IL United States std test. As Wellcome Library archivist Natalie Walters pointed out in a post on the connection between BioShock and the Gillies Archive: That nearly 100 years after similar images are used to frighten people in a computer game, gives us a peek into what life must have been like for folks who sustained such disfiguring injuries." (She adds: How courageous these men were to permit themselves to be photographed with extensive injuries, and to undergo treatments that often made them appear worse before they looked better.")

Std Test near me Abingdon. 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 use of identifiable men 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 used, and there the matter finished." Bamji drew a clear distinction between the utilization of such pictures in a job like BioShock, where they were disassociated from the names and narratives of the patients, and Hartley's Project Faade. Std Test nearby Illinois. I don't have any problem with all the display of pictures in a historic context, as without this folks do not comprehend what war can do."

Should we confine accessibility to upsetting digital images to individuals who we can be sure will see them in proper 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 sets have lately posted a run of quiet medical pictures from between 1929 and 1945 , some of which signify what Sappol calls difficult themes": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 movie made at Cook County Hospital in Chicago , which shows four children that are dying of rabies. The patients convulse, fight, bleed from the mouth; they are inconsolable, even as offer them water or gloved adult hands reach from off screen to hold them.

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Sappol does not believe it should be the job of the librarian or archivist to determine that the people can not handle looking at such images. 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 type of cop of 'who can view.' " With the NLM's electroshock therapy movies from the 1930s, Sappol says, Some of the people in this film ... look like they definitely do not consent to the process, and it is disturbing to see. I could say 'This man doesn't 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 interest we feel about such pictures, he claims, isn't shameful, but simply human.

The issue is further complicated by the fact that visibility is preferred by some subjects. This is the situation with all the Thalidomide Trust archive, which contains medical case files on individuals 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 viewpoints of thalidomiders themselves on what should occur with their case files fluctuate widely, but some undoubtedly need their files and images made available for research as a purposeful action to open up argument."Of course, there's not any method to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be seen or remain concealed. Nevertheless, the modern case of thalidomide demonstrates that we should not presume that publication is tantamount to violation.

Nor should we assume 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 also a digital historian dedicated to making her sources freely available. Abingdon IL std test. In 2010, Posner posted about the ethical quandary she faced when requested to collaborate on a slideshow of lobotomy photographs with a producer at NPR's show Science Friday. 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 finally went ahead with the Science Friday slideshow, reasoning that by asking audiences to choose a second look at the before" pictures of patients, which Freeman presented for his own goals as broken," she might be able 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 grandpa, lobotomized and who he'd never met, had been institutionalized in West Virginia. The commenter wrote: I do not care if it's an image of him having this done I only want and need to see a picture of him so MUCH, and I haven't seen a picture of my grandpa, never, ever. Can you tell me how to get to these archives?" If Posner had not gone with Science Friday, it might have been considerably harder for the commenter to find her; the connection might not have been made. Std test near me Abingdon.

Eventually, there's a religious argument for making such images available. IL United States Std Test. Even if medical pictures may be misused, Michael Sappol says, I don't desire that chance to prevent these things that are actually amazing files of the human experience from being seen. ... We can learn from them, they can redeem us in some way. They are able to supply us with some form of curriculum 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 images, there's a power they have over us, and we've got to acknowledge 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."

However, a vanitas demands space for contemplation---a space the Web appears ill prepared to offer. Susan Sontag's final book, Regarding the Pain of Others (2003), was written as the Web was in the process of scattering photographs to the four winds. Sontag wrote that photos of suffering could be a memento mori " and function 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 difficult to come by." One wonders what she might have made of Pinterest if she believed that about publications, art galleries, and television.

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