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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 website, raises questions about medical images that are historical, and when and in what media it's appropriate to view them. It is one thing to take a beautifully bound book apart into a silent armchair and have a one-on-one encounter with all with a dignified man with a bulbous, untreated pendant tumor, or the face of an infant wizened by tertiary syphilis. It is another to see the exact same faces flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated pictures and detached from the context of Barnett -providing scholarship.
Afflictions, most of which are now rare in the Western world organize the Sick Rose: gout, cholera, tuberculosis, advanced stages of syphilis. On the Internet, the patients' suffering runs the danger of being seen as classic"---nearly comical in its awful extremity and its space from our own time. In a blog post about the procedure for assembling and later marketing The Sick Rose, Barnett admitted to a sense of unease" about sending the pictures away into the whole world, worrying concerning the kitsch, knowing, and emptily ironized approach" that could greet the images. (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 images of something that happened to someone somewhere. They aren't visualized."
As historic medical images go archivists, scholars and digital are being forced to consider the advantages of disseminating the unquestionably significant and interesting record of the development of medical practice with matters that the pictures will soon be misunderstood and misused. Making the images accessible will probably result in some tone deaf uses, lacking empathy and respect at best---manipulating the shock value of an at body disfigured face or worst. On the other hand, digitization of the kinds of pictures that were once available only to researchers with the resources to travel to archives can do a lot of great. Such visibility can raise awareness about past wrongs, ease the families of former patients and connections between historians provide us with a 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 place the photos we are publishing with this specific article behind a digital scrim, allowing you, the reader, to decide whether to see them.)
Here's one instance that demonstrates how much such digitized pictures can slip from their circumstances. 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 specific unit treating injuries that necessitated maxillofacial surgery. Gillies commissioned artists and photographers to document his patients' presurgical injuries, using the images to plan his team's approach.
These photographs ended up on the Web as a portion 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 London's National Army Museum. The endeavor, Hartley writes on his web site , was meant to explore the effect of veterans' wartime injuries and following facial operations on their lives.
Following the exhibit had closed but the digital images had another life. Some photos from the Endeavor Faade archive ended up used in the design of the genetic mutants (splicers") that players of the videogame BioShock must battle. Henry Lumley, among the patients in the photographs, a pilot trainee, was injured on the day of his graduation from flying school and lived with his harm for a year before being admitted 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 compelled to roam around in virtual space, made into monsters for the amusement of gamers.
Std test nearby Alamo. Does this matter, 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 departure in battle as glorious, but facial mutilation was seen as almost 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 understand the characters they are seeing on screen were once actual men, it can still feel when they're trotted out as digitized monsters, like these men, ostracized in life, are being wronged again. Alamo NV, 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 later similar pictures are used to frighten folks in a computer game, gives us a glance into what life must have been like for folks who sustained such disfiguring injuries." (She includes: How brave these guys were to enable themselves to be photographed with extensive injuries, and to get treatments that often made them look worse before they seemed better.")
Std test nearby Alamo. Dr. Andrew Bamji, the Gillies Archives' curator, told me over e-mail 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 approach to heal 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 using such pictures in a project like BioShock, where they were disassociated from the names and stories of the patients, and the Project Faade of Hartley. Std test in Nevada. I don't have any issue with the display of pictures in a historic context, as without this folks do not understand what war can do."
Should we limit accessibility to upsetting digital images to folks who we can be sure will perceive 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 string of silent medical movies from between 1929 and 1945 , a few of which represent what Sappol calls difficult issues": leprosy, electroshock, schizophrenia. Sappol mentions, in particular, this 1929 movie made at Cook County Hospital in Chicago , which shows four kids who are dying of rabies. The patients convulse, fight, bleed from the mouth; they are inconsolable, even as gloved adult hands reach from off screen to hold them or offer them water.
Sappol doesn't think it should be the occupation of the librarian or archivist to decide that the public can't handle looking at such pictures. We're 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 subjects and arrogate to myself the occupation of being some type of cop of 'who can view.' " With the NLM's electroshock therapy pictures from the 1930s, Sappol says, Some of the folks in this picture ... seem like they surely don't consent to the procedure, plus it's disturbing to see. I could say 'This man doesn't desire 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 understand?" The fascination we feel about such images, he claims, isn't shameful, but merely human.
The issue is further complicated by the fact that some subjects prefer visibility. This is the case with the Thalidomide Trust archive, which includes 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 viewpoints of thalidomiders themselves on what should occur with their case files fluctuate widely, but some definitely need their files and images made accessible for research as a willful act to open up disagreement."Of course, there is not any way to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be observed or remain concealed. But the modern example of thalidomide reveals that we should not presume that publication is tantamount to violation.
Nor should we presume 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 accessible. Alamo NV 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 photos 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 ultimately went ahead with the Science Friday slideshow, reasoning that by asking viewers to choose a second look at the before" pictures of patients, which Freeman presented for his own purposes as broken," she might have the ability 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, who he'd never met, had been institutionalized and lobotomized in West Virginia, where Freeman did some of his work. The commenter wrote: I have never seen an image of my grandfather, never, ever, and I don't care if it's an image of him having this done I merely want and need to see a picture of him so MUCH. Can you tell me the best way to get to these archives?" If Posner had not gone with Science Friday, it might have been considerably more difficult for the commenter to find her; the link might not have been made. Std Test near me Alamo.
Eventually, there is a spiritual argument for making such images available. NV, United States std test. Even if medical pictures might be abused, Michael Sappol says, I don't want 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 is a power they have over us, and we've got to accept or respect 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, pictures like those in the Sick Rose might remind us: This is the body, along with the end that we all come to."
Still, a vanitas demands space for contemplation---a space the Web appears ill to offer. Susan Sontag's closing book, Regarding the Pain of Others (2003), was composed as the Web was in the procedure for scattering photographs to the four winds. Sontag wrote that photographs 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 challenging to come by." One wonders what she might have made of Pinterest if she thought that about television, publications, and art galleries.
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