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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 view them. It's one thing to take a beautifully bound book apart into a quiet 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 exactly the same faces detached from Barnett's context and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images -providing scholarship.

The Sick Rose is formed by afflictions, the majority of which are now rare in the Western world: gout, cholera, tuberculosis, advanced stages of syphilis. Online, the patients' anguish runs the risk of being seen as classic"---almost amusing in its horrible extremity and its space from our own time. In a blog post about the procedure for assembling and after promoting The Sick Rose, Barnett admitted to a sense of unease" about sending the images away into the whole world, worrying about the kitsch, knowing, and emptily ironized approach" that could greet the pictures. (When Wired ran a slideshow of pictures 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 pictured."

As historic medical images go digital, scholars and archivists are being compelled to weigh the advantages of disseminating the interesting and undoubtedly important record of the development of medical practice with concerns the images will probably be misused and misunderstood. Making the images accessible will almost surely result in some tone-deaf uses and regard at best---manipulating the shock value of a disfigured face or body at On the other hand, digitization of the kinds 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, facilitate the families of former patients and connections between historians provide us with a fresh strategy to consider our own mortality. (Because there are great arguments on either side, and because these medical images could be disturbing to some readers, we have decided to put the photographs we're publishing with this particular article behind a digital scrim, allowing you, the reader, to choose whether to see them.)

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Here's one instance that shows how much such digitized photos can slip from their contexts. Art historian Suzannah Biernoff has written about the destiny 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 component 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 strategy.

These pictures ended up on the Web as part of a mid-2000s exhibit titled Project Faade (now archived through the Wayback Machine ). The project, which was financed 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 artwork that Hartley made with inspiration from these archives afterwards formed the basis of an exhibit at London's National Army Museum. The job, 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, but the digital images had another life. Some photographs from the Job Faade archive ended up used in the plan of the genetic mutants (splicers") that players of the videogame BioShock must battle. One of many patients in the pictures, a pilot trainee, Henry Lumley, lived with his harm for a year and was injured on the day of his graduation from flying school before being admitted to Gillies' attention. 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 roam around in virtual space, made into monsters for the entertainment of gamers.

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Std test nearby Charlton Depot. Does this issue, given that many (most?) BioShock players will never 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 nearly black---a fate worse than death"---and images of soldiers injured in this manner were censored, lest they diminish morale. So if gamers never understand the characters they are seeing on screen were once real men, it can nevertheless feel when they are trotted out as digitized monsters, like these guys, ostracized in life, are being wronged again. Charlton Depot, MA 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 after similar images are used to frighten folks in a computer game, gives us a peek into what life should have been like for folks who endured such disfiguring injuries." (She includes: How courageous these men were to permit themselves to be photographed with extensive injuries, and to undergo treatments that frequently made them look worse before they seemed better.")

Std test closest to Charlton Depot. Dr. Andrew Bamji, the Gillies Archives' curator, told me over email that he approached the game's developers 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 treat the memory of veterans," Bamji wrote. He apologized and assured me that no additional such pictures would be utilized, and there the matter ended." Bamji drew a clear distinction between the use of such pictures in a job like BioShock, where they were disassociated from the names and stories of the patients, and Hartley's Project Faade. Std Test near me Massachusetts. I don't have any issue with the display of images in a historic context, as without this folks don't comprehend what war can do."

Should we confine accessibility to upsetting digital images to people who we can be certain will see 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 collections have recently posted a string of silent medical pictures from between 1929 and 1945 , a few of which represent what Sappol calls challenging themes": 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. The patients convulse, fight, bleed from the mouth; they're inconsolable, even as offer them water or gloved adult hands reach from off screen to hold them.

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Sappol doesn't think it should be the occupation of the librarian or archivist to decide that the public can not handle looking at images that are such. We are stewards of these historical materials," he told me. They don't belong to us. They belong to everybody. ... I would not like to play on behalf of the subjects and arrogate to myself the job of being some type of officer of 'who can view.' " With the NLM's electroshock therapy films from the 1930s, Sappol says, A Number of the folks in this picture ... appear like they surely do not consent to the process, and 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 know?" The interest we feel about such images, he claims, isn't black, but only human.

The issue is further complicated by the fact that visibility is preferred by some subjects. This is actually the situation with the Thalidomide Trust archive, which features 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 views of thalidomiders themselves on what should happen with their case files fluctuate widely, but some definitely need their files and pictures made accessible for research as a deliberate act to open up debate."Of course, there's not any method to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be viewed or stay hidden. But the modern example of thalidomide demonstrates that we shouldn't suppose that publication is tantamount to infringement.

Nor should we presume the Web is a serious medium than the bound-and- printed book. Historian Miriam Posner, who wrote her dissertation on medical filmmaking, is additionally a digital historian committed to making her sources publicly accessible. Charlton Depot, MA std test. In 2010, Posner posted about the ethical quandary she faced when requested to collaborate on a slideshow of photos 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 audiences to choose a second look at the before" images of patients, which Freeman presented for his own purposes as broken," she might have the ability to reveal that these faces contain more possibilities than Freeman ever saw." A commenter on the place of Posner wrote that he'd lately discovered that his grandpa, who he had never met, had been institutionalized and lobotomized in West Virginia. The commenter wrote: I have never seen an image of my grandpa, never, ever, and I actually don't care if it's an image of him having this done I need and only desire to see a picture of him so MUCH. Can you tell me the way to get to these archives?" If Posner hadn't gone ahead with Science Friday, it might have been considerably tougher for the commenter to locate her; the connection might not have been made. Std Test in Charlton Depot.

Finally, there's a religious argument for making such images available. MA, United States std test. Even if medical pictures might be misused, Michael Sappol says, I really don't need that chance to prevent these things that are actually amazing documents of the human experience from being seen. ... We can learn from them, they could redeem us in some way. They could provide us with some sort of curriculum of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, concurs 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 Actually the body, as well as the conclusion 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 written as the Web was in the method of scattering photos to the four winds. Sontag wrote that photographs of suffering might be a memento mori " and serve as a still point around which to consider mortality. But she wondered how this could work---or fail to work---in a modern society," where space allowed for being serious is challenging to come by." If she thought that about art galleries, novels, and television, one wonders what she may have made of Pinterest.

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