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The experience of looking at The Sick Rose, which is a good-curated print display of images that are freely accessible digitally on the Wellcome Images site, raises questions about medical pictures that are historical, and when and in what media it is appropriate to view them. It's one thing to take a beautifully bound book apart into a silent armchair and have a one-on-one encounter with the face of a baby wizened by tertiary syphilis, or with a dignified man with a bulbous, untreated pendant tumor. It is another to see the exact 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.
The Sick Rose is organized by afflictions, the majority of which are now rare in the Western world: cholera, gout, tuberculosis, advanced stages of syphilis. Online, the patients' anguish runs the risk of being seen as classic"---nearly amusing in its dreadful extremity and its space from our own time. In a blog post about the process of assembling and later marketing The Sick Rose, Barnett admitted to a sense of unease" about sending the images off into the whole world, worrying concerning the kitsch, understanding, and emptily ironized approach" 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 images of something that happened to someone somewhere. They're not envisioned."
As historic medical images go digital, scholars and archivists are being forced to weigh the benefits of disseminating the undoubtedly significant and fascinating record of the development of medical practice with concerns that the images will be misused and misunderstood. Making the images available will almost certainly lead to some tone-deaf uses and respect at best---using the shock value of a disfigured face or body at On the flip side, 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 past wrongs, ease the families of former patients as well as links between historians supply us with a fresh approach to consider our own mortality. (Because there are excellent arguments on either side, and because these medical images may be disturbing to some readers, we've chosen to place the photographs we're printing with this article behind a digital scrim, which allows you, the reader, to choose whether to view them.)
Here's one instance that demonstrates how far such digitized pictures can slip away from their circumstances. 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 particular unit treating injuries that demanded maxillofacial surgery. Gillies commissioned photographers and artists to record his patients' presurgical injuries, using the pictures to plan his team's approach.
These photos ended up on the Web as part of a mid-2000s exhibition titled Project Faade (now archived through 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 graphics that Hartley made with inspiration from these archives later formed the foundation of an exhibit at the National Army Museum in London. The project, Hartley writes on his website , was meant to explore the impact of veterans' wartime injuries and subsequent facial surgeries on their lives.
But the digital images had another life following the exhibition had closed. Some pictures from the Project 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 harm 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 compelled to drift around in virtual space, made into monsters for the amusement of gamers.
Std Test in Oquawka. Does this issue, given that many (most?) BioShock players WOn't ever know who these guys 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 almost black---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 the characters they are seeing on screen were once real men, it can still feel when they are trotted out as digitized monsters, like these men, ostracized in life, are being wronged again. Oquawka, 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 almost 100 years after similar pictures are used to frighten folks in a computer game, gives us a glance into what life must have been like for people who sustained such disfiguring injuries." (She includes: How brave these men were to allow themselves to be photographed with extensive injuries, and to undergo treatments that frequently made them appear worse before they appeared better.")
Std test nearest Oquawka. Dr. Andrew Bamji, the Gillies Archives' curator, told me over email that he approached the game's programmers after finding out about this use and succeeded in contacting one. I pointed out that the usage of identifiable guys in the context 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 utilized, 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 issue with the display of images in a historical context, as without this people do not comprehend what war can do."
Should we restrict 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 collections have lately posted a series of silent medical movies from between 1929 and 1945 , a few of which symbolize what Sappol calls hard issues": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 picture made at Cook County Hospital in Chicago , which shows four kids that are dying of rabies. Struggle, the patients convulse, bleed from the mouth; they're inconsolable, even as offer them water or gloved adult hands reach from off screen to hold them.
Sappol does not believe it should be the job of the librarian or archivist to determine that the public can't handle looking at such images. 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 areas and arrogate to myself the occupation of being some kind of officer of 'who can view.' " With the NLM's electroshock therapy films from the 1930s, Sappol says, Some of the folks in this movie ... look like they certainly don't consent to the procedure, plus it is disturbing to see. I could say 'This person does not want 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 curiosity we feel about such images, he argues, is not black, but simply human.
The issue is further complicated by the fact that visibility is preferred by some subjects. This really is the situation with the Thalidomide Trust archive, which contains medical case files on people 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 happen with their case files fluctuate widely, but some definitely need their files and pictures made available for research as a willful action to open up disagreement."Of course, there's no method to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be viewed or remain concealed. Nevertheless, the modern example of thalidomide reveals that we should not presume that publication is tantamount to infringement.
Nor should we assume 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 publicly accessible. Oquawka IL std test. In 2010, Posner posted about the ethical quandary she faced when asked to collaborate on a slideshow of pictures that were lobotomy 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 simply asking observers to take a second look at the before" images of patients, which Freeman presented for his own purposes as broken," she may have the capacity to show that these faces contain more options than Freeman ever saw." A commenter on Posner's place wrote that he had lately discovered that his grandfather, lobotomized and who he'd never met, had been institutionalized in West Virginia, where Freeman did some of his work. The commenter wrote: I have never seen an image of my grandfather, never and I don't care if it is an image of him having this done I only want and desire to see a picture of him so MUCH. Can you tell me how to get to these archives?" It might have been much more challenging for the commenter to find her if Posner had not gone ahead with Science Friday; the connection mightn't have been made. Std test near Oquawka.
Finally, there is a spiritual argument for making such images accessible. IL, United States Std Test. Even if medical pictures may be misused, Michael Sappol says, I do not want that possibility to prevent these things that are actually amazing documents of the human encounter from being seen. ... We can learn from them, they could redeem us in some way. They can provide us with some sort of curriculum of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, agrees on this particular point: There's a power behind these images, there's a power they have over us, and we have 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, pictures like those in the Sick Rose might remind us: This Is Actually the body, and the end that we all come to."
Still, a vanitas requires space for contemplation---a space the Web seems ill to offer. Susan Sontag's closing book, Regarding the Pain of Others (2003), was written as the Web was in the process of scattering pictures to the four winds. Sontag wrote that photographs of suffering could be a memento mori " and function as a still point around which to consider mortality. But she wondered how this might work---or fail to work---in a modern society," where space allowed for being serious is hard to come by." If she believed that about television, novels, and art galleries, one wonders what she might have made of Pinterest.
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