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The experience of looking at The Sick Rose, which is a good-curated print presentation of images that are freely accessible digitally on the Wellcome Images site, raises questions about historic medical pictures, and when and in what media it is appropriate to view them. It is one thing to take a beautifully bound book aside 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 Barnett's circumstance and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images -supplying scholarship.

Afflictions, most of which are now rare in the Western world organize the Sick Rose: gout, cholera, tuberculosis, advanced phases of syphilis. Online, the patients' anguish runs the danger of being seen as classic"---nearly comical in its dreadful extremity and its space from our own time. In a blog post about the process of assembling and after marketing The Sick Rose, Barnett admitted to a sense of unease" about sending the images away into the planet, worrying regarding the kitsch, knowing, and emptily ironized approach" that could greet the pictures. (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 images of something that happened to someone somewhere. They're not pictured."

As historic medical pictures go digital, scholars and archivists are being compelled to weigh the advantages of disseminating the fascinating and definitely significant record of the progression of medical practice with matters the images will likely be misunderstood and misused. Making the pictures accessible will almost certainly lead to some tone deaf uses, lacking empathy and regard at best---manipulating the shock value of an at body disfigured face or On the other hand, digitization of the sorts of images which were once available only to researchers with the means to travel to archives can do plenty of good. Such visibility can raise consciousness about previous wrongs, ease connections between historians and also the families of former patients , even supply us with a brand new method to consider our own mortality. (Because there are good arguments on both sides, and because these medical images may be upsetting to some readers, we've decided to put the photographs we are publishing with this specific post behind a digital scrim, which allows you, the reader, to decide whether to view them.)

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Here's one case that shows how much such digitized pictures can steal away from their circumstances. 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 needed maxillofacial surgery. Gillies commissioned photographers and artists to record his patients' presurgical injuries, using the images to plan the approach of his team.

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 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 visuals that Hartley made with inspiration from these archives afterwards formed the basis of an exhibition at the National Army Museum in London. The job, Hartley writes on his site , was intended to explore the effect of veterans' wartime injuries and following facial surgeries on their lives.

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But the digital images had another life following the exhibit had closed. Some photographs from the Project 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 pictures, Henry Lumley, a pilot trainee, lived with his harm 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 a picture of the BioShock character in question) Lumley and his fellow patients are now forced to wander about in virtual space, made into monsters for the entertainment of gamers.

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Std Test nearby Cloverly. 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 death in battle as glorious, but facial mutilation was seen as nearly shameful---a fate worse than death"---and pictures of soldiers injured in this way 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 nevertheless feel like these guys, ostracized in life, are being wronged again when they are trotted out as digitized monsters. Cloverly MD, 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 later comparable 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 includes: How brave these men were to allow themselves to be photographed with extensive injuries, and to get treatments that frequently made them seem worse before they seemed better.")

Std test in Cloverly. 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 use of identifiable guys in the context of the game was an appalling way to heal 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 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 nearest Maryland. I don't have any issue with all the display of pictures in a historical context, as without this folks 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 historic and modern medical display, has an argument to the contrary. The NLM's digital sets have recently posted a run of hushed medical movies from between 1929 and 1945 , a few of which signify what Sappol calls tough 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. 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 doesn't believe it should be the occupation of the librarian or archivist to determine that the public can not 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 would not like to act on behalf of the subjects and arrogate to myself the job of being some kind 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 movie ... appear like they surely do not consent to the procedure, and it is disturbing to see. I could say 'This man does not want to be on camera, they are being humiliated.' But this is from. If we never get to see this, who gets to understand?" The fascination we feel about such images, he argues, is not black, but only human.

The matter is further complicated by the fact that a few subjects prefer visibility. This is the case with all the Thalidomide Trust archive, which features medical case files on people produced withsevere birth defects after their mothers took the drug thalidomide to relieve 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 occur with their case files fluctuate widely, but some definitely want their files and images made accessible for research as a deliberate action to open up discussion."Of course, there's no method to ask the patients whose bodies appear in The Sick Rose whether they'd prefer to be seen or remain hidden. Nevertheless, the modern example of thalidomide shows that we must not assume 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. Cloverly MD 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 pictures that were lobotomy. Neurologist Walter Freeman, who carried out more than 3,500 of the processes, photographed and filmed his patients before and after their surgeries.

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 purposes as broken," she may have the ability to reveal that these faces comprise more options than Freeman ever saw." A commenter on Posner's place wrote that he'd lately learned that his grandfather, who he'd never met, had been institutionalized and lobotomized in West Virginia, where Freeman did some of his work. The commenter wrote: I don't care if it's a picture of him having this done I merely desire 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?" It might have been much more challenging for the commenter to find her if Posner hadn't gone with Science Friday; the connection mightn't have been made. Std Test closest to Cloverly.

Finally, there is a religious argument for making such pictures accessible. MD United States std test. Even if medical pictures may be abused, Michael Sappol says, I do not need that chance to prevent these things that are really amazing files of the human experience from being seen. ... We can learn from them, they can redeem us in some way. They can supply us with some kind 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 is a power they have over us, and we've got to accept or honor this at some point." He compares the images 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 Actually the body, and the end that we all come to."

However, a vanitas requires space for contemplation---a space the Web looks ill to offer. Susan Sontag's closing 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 could be a memento mori " and serve as a still point around which to consider mortality. But she wondered how this might function---or fail to work---in a modern society," where space allowed for being serious is tough to come by." One wonders what she may have made of Pinterest if she believed that about publications, art galleries, and television.

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