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The experience of looking at The Sick Rose, which is a good-curated print display of pictures that are accessible digitally on the Wellcome Images website, raises questions about historical medical images, and when and in what media it's appropriate 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 an infant 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 the context of Barnett and flit by on Pinterest, Tumblr, or Twitter, in a jumble of other unrelated images -providing scholarship.
Afflictions, most of which are now rare in the Western world organize the Sick Rose: cholera, tuberculosis, gout, advanced stages of syphilis. On the Internet, the patients' suffering runs the danger of being seen as vintage"---almost comical in its dreadful extremity and its space from our own time. In a blog post about the method of assembling and later marketing The Sick Rose, Barnett admitted to a sense of unease" about sending the images away into the planet, worrying about the kitsch, understanding, and emptily ironized attitude" that could greet the images. (When Wired ran a slideshow of photos 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 happened to someone somewhere. They're not pictured."
As historic medical images go archivists, scholars and digital are being forced to weigh the advantages of disseminating the undoubtedly important and fascinating record of the progression of medical practice with concerns that the pictures will probably be misused and misunderstood. Making the pictures available will almost surely cause some tone-deaf uses and aspect at best---manipulating the shock value of a disfigured face or body at worst. On the other hand, digitization of the types of pictures that were once accessible only to researchers with the means to travel to archives can do plenty of great. Such visibility can raise consciousness about previous wrongs, facilitate the families of former patients as well as links between historians , even provide us with a new method to think about 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 set the photos we're printing with this article behind an electronic scrim, which allows you, the reader, to choose whether to see them.)
Here's one instance that demonstrates how far such digitized photos can slip away 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 special unit treating injuries that needed maxillofacial surgery. Gillies commissioned photographers and artists to record his patients' presurgical injuries, 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 funded 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 art that Hartley made with inspiration from these archives after formed the foundation of an exhibit at London's National Army Museum. The job, Hartley writes on his website , was meant to learn more about the effect of veterans' wartime injuries and following facial surgeries on their lives.
After the exhibit had closed, but the digital images had another life. Some photos from the Endeavor 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, 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 admitted to Gillies' attention. Lumley died at age 26, of postoperative complications. (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 roam about in virtual space, made into monsters for the amusement of gamers.
Std test nearest West Creek. 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 virtually black---a fate worse than death"---and pictures of soldiers injured in this way were censored, lest they reduce morale. So if gamers never realize that the characters they're seeing on screen were once actual men, it can still feel when they're trotted out as digitized monsters, like these guys, ostracized in life, are being wronged again. West Creek NJ United States Std Test. As Wellcome Library archivist Natalie Walters pointed out in a post on the connection between BioShock as well as the Gillies Archive: That nearly 100 years after comparable images are used to frighten people in a computer game, gives us a peek into what life must have been like for people who endured such disfiguring injuries." (She adds: How courageous these guys were to allow themselves to be photographed with extensive injuries, and to get treatments that frequently made them appear worse before they looked better.")
Std test near West Creek. 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 men 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 pictures would be utilized, and there the matter finished." Where they were disassociated from the names and narratives of the patients, and Hartley's Project Faade Bamji drew a clear distinction between using such pictures in a job like BioShock. Std test nearby New Jersey. I don't have any issue with the display of images in a historical context, as without this people don't understand what war can do."
Should we limit access to upsetting digital images to folks who we can be sure will see them in proper 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 groups have lately posted a run of quiet medical movies from between 1929 and 1945 , a few of which represent what Sappol calls hard subjects": 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 offer them water or gloved adult hands reach from off screen to hold them.
Sappol doesn't think it should be the job of the librarian or archivist to decide 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 wouldn't like to act on behalf of the subjects and arrogate to myself the occupation of being some kind of policeman of 'who can view.' " With the NLM's electroshock therapy movies from the 1930s, Sappol says, A Number of the people in this picture ... seem like they definitely do not consent to the process, plus it is disturbing to see. I could say 'This person doesn't need 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 interest we feel about such pictures, he argues, isn't shameful, but simply human.
The issue is further complicated by the fact that visibility is preferred by some subjects. This is actually the case with the Thalidomide Trust archive, which contains medical case files on folks produced 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 viewpoints of thalidomiders themselves on what should happen with their case files vary widely, but some undoubtedly want their files and images made accessible for research as a purposeful act to open up debate."Of course, there is not any way to ask the patients whose bodies appear in The Sick Rose whether they would prefer to be seen or stay concealed. But the modern case of thalidomide demonstrates that we shouldn't suppose that publication is tantamount to infringement.
Nor should we presume that 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 additionally a digital historian dedicated to making her sources publicly available. West Creek, NJ Std Test. In 2010, Posner posted about the ethical quandary she faced when requested to collaborate on a slideshow of lobotomy pictures with a producer at NPR's show Science Friday. Neurologist Walter Freeman, who carried out more than 3,500 of the procedures, photographed and filmed his patients before and after their surgeries.
But Posner ultimately went ahead with the Science Friday slideshow, reasoning that by simply asking audiences to take a second look at the before" pictures of patients, which Freeman presented for his own purposes as broken," she might manage to show that these faces include more options than Freeman ever saw." A commenter on Posner's place wrote that he'd lately learned that his grandpa, who he'd never met, had been institutionalized and lobotomized in West Virginia. The commenter wrote: I haven't 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 only desire and desire to see a picture of him so MUCH. Can you tell me the way to get to these archives?" It might have been considerably harder 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 West Creek.
Finally, there is a spiritual argument for making such pictures accessible. NJ, United States Std Test. Even if medical images might be abused, Michael Sappol says, I actually don't need that possibility to prevent these things that are really amazing files 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 kind of curriculum of human suffering. ... Looking at them makes life richer and deeper." Barnett, despite his misgivings, concurs on this point: There is a power behind these images, there's a power they have over us, and we have to acknowledge 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, and the end that we all come to."
Still, a vanitas requires space for contemplation---a space the Web appears 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 photographs to the four winds. Sontag wrote that pictures of suffering could be a memento mori " and function as a still point around which to contemplate mortality. But she wondered how this might function---or fail to work---in a modern society," where space reserved for being serious is tough to come by." One wonders what she might have made of Pinterest if she believed that about art galleries, publications, and television.
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