More Than Medicine: Social Justice and Feminist Movements for Health

COS-Series-Twitter-R1 Event 1005Today’s guest post is written by Jennifer Nelson, Professor at University of Redlands, specializing in women’s history, the history of feminism in the United States, and medical histories associated with social justice movements. She is the author of More Than Medicine (NYUPress, 2015).

On Thursday, October 5, Nelson will give her talk, “More Than Medicine: Social Justice and Feminist Movements for Health.” To read more about this lecture and to register, go HERE.

I begin my story of social justice and feminist movements for health with the Mound Bayou demonstration clinic—located in the Mississippi Delta. The clinic was founded by medical doctors who had been part of the Medical Committee for Human Rights (MCHR). Most had come to Mississippi to volunteer during the 1964 Freedom Summer, although several others were locals active in the Delta Ministry, a Mississippi based Civil Rights organization.

Dr. H. Jack Geiger and the other founders of the Delta Health Center clinic worked with the Mound Bayou community to prioritize health needs. They quickly discovered that community members needed more than traditional medicine: they demanded food, jobs, and housing—linking these to the promotion of health. The clinic included a cooperative farm that grew vegetables for the community, since most of what was grown in the Delta was for commercial consumption. Click HERE to listen to Dr. Geiger talk about his experiences in Mississippi at the National Library of Medicine exhibit on the Delta Health Center.

Many historians of social movements have emphasized that the women’s liberation movement emerged from the Civil Rights movement. I also pay attention to this connection, but focus on the use of medicine to achieve social justice goals in both the Civil Rights and women’s liberation movements. In both of these contexts, activists expanded the meaning of medicine in the process.

In the 1980s women’s health movement feminists were also grappling with conversations about race and racism. Since the early 1970s, women of color had been demanding that feminists pay more attention to issues raised by women of color. In the 1970s much of the focus was on sterilization abuse. In the 1980s attention shifted to HIV transmission, safer sex, and AIDS. Dazon Dixon Diallo, one of the only women of color working at the Atlanta Feminist Women’s Health Center in the 1980s, focused on developing a program called the Women with AIDS Partnership Project.

Here is a clip from a talk given by Diallo about her organization SisterLove, which she formed when she left the Atlanta FWHC to more directly address HIV/AIDS:

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Dazon Dixon Diallo. (Click image to watch video).

My book also focuses on Loretta Ross, one of the most important founders of the Reproductive Justice Movement, which sought to broaden the feminist discourse around “choice” to address the systemic problems associated with poverty and discrimination that prevented many women of color from simply choosing to have or not have children. Ross’s work connects back to the Civil Rights efforts in Mound Bayou among MCHR activists and local organizers with the Delta Health Center. Ross, by forging a reproductive justice framework, maintained that health promotion for poor women could not rest on medicine alone.

More Than Medicine: Social Justice and Feminist Movements for Health is the third event in the three part event series, Who Controls Women’s Health?: A Century of Struggle. The series examines key battles over women’s ability to control their bodies, health choices, and fertility. It is developed in collaboration with the Museum of the City of New York and supported by a grant from Humanities New York.

So, You Want to Build a Digital Program? (Part 2)

By Robin Naughton, Head of Digital and Audrey Sage Lorberfeld, Digital Technical Specialist

This is the second in a two-part series on the creation of the Academy Library’s Digital Collections and Exhibits website. Part 1 is here.

Sometimes opportunities arise that you just can’t pass up. In late May 2017, our Curator of Rare Books and Manuscripts, Anne Garner, suggested a digital exhibit of items from our collection that would showcase the history behind many of the magical elements from J.K. Rowling’s beloved Harry Potter series; and suggested its launch coincide with Harry Potter and the Philosopher’s Stone‘s 20th anniversary on June 26. While we were a new digital team of two with new digitization equipment, we were up for the challenge. That is how we wound up creating the online exhibit, “From Basilisks to Bezoars: The Surprising History of Harry Potter’s Magical World,” in a mere 6 weeks.

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Leo from Aldus Manutius’ Astronomici veteres (1499).

Our first stop was to Garner, who, within a week and a half, handpicked two objects (including our infamous bezoar) and 34 images from over 20 different books  for us to digitize. While we were hustling to photograph these items in the lab, Garner was busy creating robust image metadata for us to ingest into Islandora. Next, we got to work churning out XML records through the use of OpenRefine and an Apple script, and then we were in the quality assurance phase. Once everything was checked, it was time to launch!

Of course, there were bumps along the road, too. At one point, we realized we had digitized the wrong phoenix! At another point, we had to go into all of our XML records and manually add in a download button. There were also some late Friday and Sunday nights spent working on our laptops to make the collection as perfect as possible. Bumps notwithstanding, we launched on-time, and the collection received a lot of great attention.[1]

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Anne Garner takes us through the images she has selected for digitization for our Harry Potter-inspired collection.

So, what did we learn from the launch of our digital program? We quickly discovered that it takes time and skill to create metadata. Both Garner and our Head of Cataloging, Rebecca Filner, expertly provided us with extremely detailed metadata for our current collections. Even in its quickest iteration, metadata-creation takes weeks![2]

We also learned that no digitized image is wasted. As we mentioned in Part 1, many of the digitized rare books with which we launched our Digital Collections were photographed for a separate project the Library had completed a few years earlier. The photographs were impeccable, so why double the work? Instead, we used what the photographer, Ardon Bar-Hama, gave us and co-opted these previously-shot images for our Digital Collection site. (Some notable examples are the Apicius and the Guy de Chauliac.)

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Our Head of Digital, Robin Naughton, trying out the new equipment.

And finally, we learned that the easiest part of the digitization process is photographing the items. As long as your equipment works, you are good to go! We received training by our expert Conservation staff in how to handle rare items, and we hit the ground running.

For those wishing to start a digital lab in your library, we have some hard-earned advice, all of which focuses on communication and outreach (the tech is the easy part!):

First, reach out to local colleagues who have been doing this longer than you. We visited many digital labs before our launch, including the beautiful labs at Columbia University, The Frick Art Reference Library, and the Museum of the City of New York. Each lab had a different setup, different workflows, and different amounts of staff with unique backgrounds. Without this exploratory research, we have no doubts our lab would not have done as well as it has.

Second, join listservs. Without the listservs to which we subscribe, we would not have gained nearly as much knowledge as we did before launch. Two great listservs to join are ALA’s digipres listserv and the ImageMuse Yahoo group’s listserv. We even reached out to a wonderful colleague from Coastal Carolina University because we admired how he used OpenRefine and the command line to batch-create and –export XML metadata records. He shared his script with us, and the rest is history. We now use his workflow in our lab for nearly every project.

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Now we are even sharing our knowledge with others!

Third: join or create a digitization-related community in your area. By way of using the free, open-source Islandora platform for our digital collections, we became part of a very active and supportive network of Islandora admins, managers, developers, and vendors around the world. While that is incredible, it is also nice to have a support system in your own backyard. So, we co-founded the New York City Islandora Working Group with some colleagues from other institutions. Our group is open to anyone, regardless of whether they currently use Islandora. We meet once per month and share skills, ask each other questions, and, of course, eat pizza and sip wine together. It’s one of the most worthwhile professional endeavors we have been a part of, and our members have been instrumental in getting our lab up and running.

The secret to success really is communication. Talk to people, and you will learn so much!

Footnotes:

[1] “Study for your O.W.L.s with Library’s Harry Potter-Themed Online Collection” (DNAInfo); “There’s a New Digital Harry Potter Book Collection from NYC’s New York Academy of Medicine Library” (untapped cities); “Celebrating 20 Years of the Philosopher’s Stone Inside the Mini-Hogwarts in New York City” (The Verge); “Attention Harry Potter Fans: There’s A Mini-Hogwarts In East Harlem” (Gothamist)
[2] For those library-science fans among you, why didn’t we just pull the metadata from our online catalog? We did! But we encountered a lot of library-speak that we did away with for our Digital Collections audience and wanted to add some new metadata.

So, You Want to Build a Digital Program? (Part 1)

By Robin Naughton, Head of Digital and Audrey Sage Lorberfeld, Digital Technical Specialist

There is a moment before a system is officially live when all the pieces align to create perfection. That moment arrived for us on June 5, 2017, when we launched our Digital Collections and Exhibits website. The launch represented the culmination of 18 months’ work towards implementing a new digital software system (Islandora), migrating content, digitizing new material, and building an internal digital lab.

We took a structural approach to this undertaking. The first structure we wanted to tackle was our software. We selected Islandora, an open-source software framework, which offered an active community and support for small institutions. The community was a major driver in our decision. We wanted support from a diverse group of people who included librarians, software developers, and administrators.

To get our Islandora instance set up, we opted for a vendor-hosted solution. Since we were new to the system, and had a small team with no developers, this was the best move for our institution. Out of a few different vendors, we selected DiscoveryGarden. They were instrumental in getting our system up and running (including customizing our theme to align with the Academy’s branding). We ended up with an amazing homepage that shows users all the resources the Library has to offer.

Wireframe for new theme development (Left). Design mock-up for theme (Right).

Next, we shifted our focus to the content: what would fill the pages of our Islandora repository? A few years prior, courtesy of George Blumenthal, photographer Ardon Bar-Hama took photographs of some of the Library’s rarest books. We determined that co-opting already-digitized content would be the perfect first project for our new system.  Better still, Anne Garner, the Library’s Curator of Rare Books and Manuscripts, had already written descriptions for these images. With the help of digital assistants, volunteers, and interns, the images were cropped, separated, and augmented with robust metadata. This project alone gave us 13 rare books to showcase in our repository without requiring any new digitization.

For our next project, we explored migrating an older digital collection from our legacy system, ContentDM, to our new Islandora system. We chose the William H. Helfand Collection of Pharmaceutical Trade Cards because the digitization that took place almost a decade prior had not captured the entire run of the collection. So, not only could we migrate the old content from ContentDM, we could also add new content.[1]

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The previously-digitized cards from the William H. Helfand Pharmaceutical Trade Cards collection on ContentDM.

Armed with lots of digital images at this point, we began the long-awaited test and launch phases of this process. Such questions as will the system render correctly? Will it handle the large number of users? What are the load times? went through our heads frequently. There were many hours spent performing quality assurance on everything, but that is necessary. Do it right once, and you will be set for the future.

At the same time as all of this pre-launch processes were taking place, we were also building our physical digital lab. We purchased a refurbished digital, medium-format camera, strobe lights and Capture One software for cultural heritage institutions, dusted off an old copy-stand we found hiding out in the Library, and outfitted it on top of a workbench to serve as our digitization environment.

Building a digital program takes time and resources. We are fortunate to have a supportive institution and to be part of a very active community that has done, is doing, and planning to do the same or similar digitization projects. On the morning of June 5, 2017, everything worked. The launch was a success, and the feedback we received was stellar.

Coming up in part 2, we will take you through the creation process behind our Harry Potter-inspired digital collection; go over general lessons we learned over the past 2 years; and share some recommendations for those of you thinking of starting a digital lab of your own.

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Our digital lab setup. We’re ready to digitize everything!

Footnote:
[1] For those of you who like to get into the nitty gritty of digital asset management, in order to migrate these legacy Helfand scans from ContentDM to Islandora, we exported the ContentDM metadata into Excel spreadsheets, conducted an inventory of these original images, added to the inventory data related to the new items we were putting into the collection, and voilá!

The Language of Textiles and Medicine

Today’s guest post is written by Kriota Willberg, New York Academy of Medicine’s Artist-in-Residence researching the history of sutures and ligatures.  Through graphic narratives, teaching, and needlework, Kriota explores the intersection between body sciences and creative practice. Starting this week, Kriota will be teaching a four-week workshop entitled “Embroidering Medicine,” which explores relationships between medicine, needlework, and gender. There is still time to register for this workshop, which begins September 14.

As an artist working with textiles and comics (two media often considered domestic or for children), I am interested in the interplay of culturally common materials, tools, and language with those of professional specialty. From the research I have done on the history of sutures and ligature, it appears that the staples of domestic needlework: thread/sinew, cloth/hide, scissors, pins, and needles have been appropriated from domestic use since the time of their invention, to assist in the repair of the body. Similarly, the language of domestic and professional needlework has been re-purposed to describe closing wounds.

Many of the texts I am reading describe the characteristics and purposes of various surgical needles, the type of textiles used for bandaging (linen, wool, cotton), and the type of thread used for various types of sutures (linen, silk, cotton, catgut). I have also found descriptions of wool and flax production by Pliny the Elder in the first century AD, an account of French silk production in 1766 from John Locke, and a couple 20th-century books detailing the history of catgut.

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Ligatures and Sutures by Bauer and Black (c1924) chapter on “Preparation of Bauer & Black Catgut.”

Although I don’t know when a physician’s sewing kit diverged from those of a seamstress or leather worker’s sewing kit, John Stewart Milne writes in his book Surgical Instruments in Greek and Roman Times:

“Three-cornered surgical needles were in use from very early times. They are fully described in the Vedas of the Hindoos… A few three-cornered needles of Roman origin have been found, although they are rare.”[1]

In addition to describing the specific uses of surgical needles, Milne also discusses the uses of domestic needles in stitching bandages by Roman physicians.[2]

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A collection of needles and probes. Source: Surgical Instruments in Greek and Roman Times (1907) by John Stewart Milne.

Galen reinforces this play between textiles, medicine, and the body by describing damage to the body through the metaphor of fabric:

“It is not the job of one art to replace one thread that has come loose, and of another to replace three or four, or for that matter five hundred… In quite general terms, the manner by which each existent object came about in the first place is also the manner in which it is to be restored when damaged.

The woof is woven into the warp to make a shirt. Now, is it possible for that shirt to sustain damage, or for that damage to be repaired, in some way which does not involve those two elements? If there is damage of any kind at all, it cannot but be damage to the warp, or to the woof, or to both together; and, similarly, there is only one method of repair, an inter-weaving of woof and warp which mimics the original process of creation.”[3]

The tandem development of textile production and medicine becomes part of the domestic-to-medical interface of textiles and their tools manifested through the language used to describe materials, tools, and stitches.

In his Major Surgery (1363), in a chapter about “sewing” wounds, Guy de Chauliac describes wrapping thread around a needle in the same method that women use to keep threaded needles on their sleeves. He also describes using hooks to bind wounds. This closure technique is attributed to wool cutters or (wool) walkers.[4] Later Ambrose Paré, paraphrasing Guy’s description of another type of suture says, “The second Suture is made just after the same manner as the Skinners sow their…furs.”[5] Paré also uses the keeping a needle on one’s sleeve description when describing surgical repair of harelip (known today as cleft lip).

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Bottom illustration showing an example of thread winding described by Paré and Guy de Chauliac. Source: The Workes of that famous Chirurgion Ambrose Parey (1634).

The language of needlework and textiles is used to educate and inform the student surgeon about the body, health, and suturing techniques.  Woof and warp, wrapping needles, closing a wound as a wool walker would fasten wool, and suturing the body with the same stitch used by a Skinner, seem to be descriptions one is expected to understand and mimic. What is a wool walker? Thanks to Wikipedia I can tell you that “walking” is a step in cloth making, also called fulling, in which one pounds woolen cloth with one’s feet to thicken and clean it.[6] I still haven’t figured out how they fasten the wool with hooks.

References:
[1] Milne, John Stewart. Surgical Instruments in Greek and Roman Times. Oxford: Clarendon Press, 1907, p.75.
[2] Milne. p.75-76.
[3] Galen. Galen : selected works ; translated with an introduction and notes by P.N. Singer. Trans. Peter N. Singer. Oxford: Oxford University Press, 1997.
[4] Guy, de Chauliac. The cyrurgie of Guy de Chauliac. Ed. Margaret S. Ogden. London, New York: Early English Text Society by the Oxford Univ. Press, 1971, p.192.
[5] Paré, Ambrose. The Workes of that famous Chirurgion Ambrose Parey Translated out of Latine and compared with the French. Trans. Th: Johnson. London: Th:Cotes and R. Young, 1634, p.327.
[7] Wikipedia. Fulling. 10 July 2017.

How to Become a Doctor (in 1949)

By Allison Piazza, Reference Services and Outreach Librarian

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How to Become a Doctor (1949) by George R. Moon.

While shelving books, I had the great pleasure of discovering a small book entitled How to Become a Doctor. Published in 1949, How to Become a Doctor is, at just 131 pages, “a complete guide to the study of medicine, dentistry, pharmacy, veterinary medicine, occupational therapy, chiropody and foot surgery, optometry, hospital administration, medical illustration, and the sciences.”

The author of the book, George R. Moon, was the Examiner and Recorder at University of Illinois Colleges of Medicine, Dentistry and Pharmacy.  As for Mr. Moon’s qualifications, the writer of the forward states: “it is probable that no one person in the world has met more students seeking advice regarding entrance to schools of medicine, dentistry and pharmacy.”

As intended, I learned quite a bit about the medical school admissions process while reading this guide. I was surprised to learn that, in 1949, not many medical schools required a bachelor’s degree for admission, with only 4 schools requiring the degree, 58 asking for three college years, and 7 indicating they would consider 2 years of college work.  This is basically unheard of today in the U.S.

Medical School by the numbers: 1948-1949 and 2016-2017

1948-1949 2016-2017
Approved U.S. 4-year medical schools 71 147
Applicants At least 20,000 53,042 [1]
Application fee $5-$10 per school $160 first school; $38 per additional school [2]
Enrollment 6,559 21,0301 [1]
Tuition at Harvard Medical School $830* $58,050 [3]
Female matriculates 11% (1947) 49.8% [1]
Medical school graduates 5,543 18,938 [4]

*The highest annual fee at any medical school in 1948-1949.

Further into the guide, Mr. Moon discusses the application process, offering a sample application from the University of Illinois.  One question from this four page application is: How and where do you spend your summer vacations?

After the application comes the interview.  Mr. Moon’s primary advice is on appearance, stating that “this is one place where the typical ‘Joe College’ attitude should be forgotten.” He goes on to say that the student should act natural and answer questions directly and fully but “avoid anything fancy.”

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Chapter images from How to Become a Doctor.

To conclude, just who was the ideal medical school applicant in 1949? Mr. Moon offers the following description:

“The ideal will, of course, have superior college grades, a broad, balanced liberal arts program, be not over 22 years of age, have high moral standards and professional ideals, be reasonably attractive personally, be poised and at ease in his interviews, speak clearly and correctly, be clean and fastidious as to dress and appearance, and have enough financial backing so that he will not be forced to work or be worried by money matters, and last but not least, be physically strong and healthy.”

References:
[1] “U.S. Medical School Applications and Matriculates by School, State of Legal Residence, and Sex, 2016-2017.” Association of American Medical Colleges, December 6, 2016.
[2] “Applying to Medical School.” Association of American Medical Colleges, n.d.
[3] “Tuition and Fees.” Harvard Medical School, November 29, 2016.
[4] “Total Graduates by U.S. Medical School and Sex, 2011-2012 through 2015-2016.” Association of American Medical Colleges, December 19, 2016.

Sample Medical College Admission Test (MCAT) questions from How to Become a Doctor:

Vocabulary:

1. AUDACIOUS: (A) splendid (B) loquacious (C) cautious (D) auspicious (E) presumptuous

Quantitative Ability:

2. It is known that every circle has an equation of the form Ax2 + Ay2 + Bx + Cy + D = 0. Which of the following is the equation of a circle?
A) 2x – 3y = 6
B) x2 – y2 + 4x – 2y + 3 = 0
C) 3x2 + 3y2 – 2x + 6y +1 = 0
D) 2x2 + 3y2 + 6x + 4y +1 = 0
E) None of the above

Understanding of Modern Society:

3. Japan today presents no immediate threat to peace in the Far East principally because:
(A) so much of the country has been devastated
(B) she has been stripped of her colonies and conquests
(C) the present Japanese constitution outlaws war
(D) the new Japanese government is much opposed to the military party
(E)there is now unity of purpose among the various interest in the Far East

Premedical Sciences:

4. Which one of the following is 75 percent carbon, by weight, and 25 percent hydrogen, by weight?
(A) 
C3H
(B) 
CH
(C) 
CH3
(D) C2H3
(E) CH4

Answers: 1. (E), 2. (C), 3. (B), 4. (E)