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The experience of looking at The Sick Rose, which is a good-curated print presentation of pictures that are freely accessible digitally on the Wellcome Images website, raises questions about historic medical images, and when and in what media it is proper to see them. It is one thing to take a beautifully bound book apart into a silent 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 the same faces detached from the context of Barnett and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images -providing scholarship.
Afflictions, the majority of which are now rare in the Western world organize the Sick Rose: cholera, tuberculosis, gout, advanced stages of syphilis. Online, the patients' anguish runs the danger of being seen as vintage"---nearly amusing in its horrible extremity and its space from our own time. In a blog post about the method of assembling and after promoting The Sick Rose, Barnett admitted to a feeling of unease" about sending the pictures away into the world, worrying about the kitsch, knowing, and emptily ironized attitude" that could greet the images. (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 imagined."
As historical medical pictures go digital, scholars and archivists are being forced to weigh the benefits of disseminating the unquestionably important and interesting record of the evolution of medical practice with matters the images will be misused and misunderstood. Making the pictures available will almost certainly cause some tone-deaf uses and respect at best---manipulating the shock value of a disfigured face or body at worst. On the other hand, digitization of the types of images which were once available only to researchers with the means to travel to archives can do lots of good. Such visibility can raise consciousness about previous wrongs, ease the families of former patients and connections between historians , even supply us with a brand new strategy to think about our own mortality. (Because there are excellent arguments on both sides, and because these medical images can be disturbing to some readers, we have decided to set the photographs we're printing with this particular article behind a digital scrim, allowing you, the reader, to choose whether to see them.)
Here's one case that shows how much such digitized pictures can steal away from their contexts. Art historian Suzannah Biernoff has written about the fate 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 necessitated maxillofacial surgery. Gillies commissioned artists and photographers to document his patients' presurgical harms, using the pictures to plan his team's approach.
These pictures ended up on the Web as a portion of a mid-2000s exhibition titled Project Faade (now archived via the Wayback Machine ). The project, 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 afterwards formed the basis of an exhibition at the National Army Museum in London. The endeavor, Hartley writes on his web site , was meant to explore the effect of veterans' wartime injuries and subsequent facial surgeries on their lives.
Following the exhibit had closed but the digital images had another life. Some pictures from the Endeavor Faade archive ended up used in the design of the genetic mutants (splicers") that players of the videogame BioShock must battle. Among the patients in the photos, Henry Lumley, a pilot trainee, lived with his injury for a year and was injured on the day of his graduation from flying school before being declared to Gillies' care. Lumley died of postoperative complications, at age 26. (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 roam about in virtual space, made into monsters for the amusement of gamers.
Std Test closest to Cropsey. Does this issue, given that many (most?) BioShock players WOn't ever 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 manner were censored, lest they diminish morale. So even if gamers never realize that the characters they are seeing on screen were once real men, it can still feel when they're trotted out as digitized monsters like these guys, ostracized in life, are being wronged again. Cropsey, IL, 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 almost 100 years later comparable pictures are used to frighten people in a computer game, gives us a glance into what life must have been like for folks who endured such disfiguring injuries." (She includes: How courageous these men were to allow themselves to be photographed with extensive injuries, and to undergo treatments that often made them look worse before they seemed better.")
Std test nearby Cropsey. 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 method to treat the memory of veterans," Bamji wrote. He apologized and assured me that no additional such pictures would be used, and there the matter finished." Bamji drew a clear distinction between the utilization of such pictures in a project like BioShock, where they were disassociated from the names and narratives of the patients, and Hartley's Project Faade. Std test near Illinois. I have no problem with the display of pictures in a historic context, as without this folks don't comprehend what war can do."
Should we confine access to upsetting digital images to folks who we can be sure will see them in appropriate context? Michael Sappol , a historian at the U.S. National Library of Medicine who has written about historic and contemporary medical display, has an argument to the contrary. The NLM's digital sets have recently posted a string of hushed medical pictures from between 1929 and 1945 , some of which symbolize what Sappol calls difficult 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're 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 job of the librarian or archivist to decide that the public can't handle looking at pictures 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 act on behalf of the areas and arrogate to myself the job of being some type of cop of 'who can view.' " With the NLM's electroshock therapy movies from the 1930s, Sappol says, A Number of the folks in this film ... appear like they definitely don't consent to the procedure, plus it is disturbing to see. I really could say 'This individual doesn't need 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 curiosity we feel about such images, he asserts, is not black, but simply human.
The issue is further complicated by the fact that a few subjects favor visibility. This really is the case with all the Thalidomide Trust archive, which comprises medical case files on individuals 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 views 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 deliberate action to open up discussion."Of course, there is no way to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be viewed or remain concealed. Nevertheless, the modern example of thalidomide shows that we shouldn't 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 dedicated to making her sources publicly accessible. Cropsey, 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 filmed his patients before and after their operations.
But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by simply asking viewers to take a second look at the before" images of patients, which Freeman presented for his own purposes as broken," she might have the capacity to reveal that these faces comprise more options than Freeman ever saw." A commenter on Posner's place wrote that he'd lately discovered that his grandfather, who he had never met, had been institutionalized and lobotomized in West Virginia. The commenter wrote: I actually don't care if it is an image 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 grandfather, never, ever. Can you tell me the way to get to these archives?" It might have been considerably tougher for the commenter to find her, if Posner hadn't gone ahead with Science Friday; the connection might not have been made. Std Test closest to Cropsey.
Eventually, there is a religious argument for making such pictures available. IL, United States std test. Even if medical images might be misused, Michael Sappol says, I actually don't desire that chance to prevent these things that are actually amazing records of the human experience from being seen. ... We can learn from them, they are able to redeem us in some way. They can provide us with some type of program of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, agrees on this point: There's a power behind these pictures, there's a power they have over us, and we have to accept or honor this at some point." He compares the pictures to a laic 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, and the conclusion 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 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 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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