Friday, March 28, 2008

History of the Multnomah County Medical Society

We received in today's mail the History of the Multnomah County Medical Society, 1884-1954, written by George M. Robins, M.D. Supplied to us by Rob Delf, current president of the Medical Society of Metropolitan Portland--the immediate successor to the MCMS--this copy of the brief history seems to be the first to have fallen into the hands of a library collection.

The first 67 pages of the text cover the history of the Society from its inception until 1954. Included are census figures for the population of Portland from 1880 to 1990, so that readers can compare membership numbers and activities from the beginning (1880 pop. 17,577) to contemporary times (1990 pop. 437,319) using the proper frame of reference.

Herein, we learn that minutes for the Society meetings are extant for the years 1884-1905, but that after 1905 "no minutes were written or have not yet been found." I wonder whether they suffered the same fate as those of the Aesculapian Club.

The history also contains a nice, concise history of medical education in Portland prior to 1887:
Medical education in the Portland area, prior to the founding of the [University of Oregon] medical school, had been either by preceptorship or by the Willamette Medical Department. There had been founded, in Portland, a Portland Medical School in 1865. Apparently, it soon became defunct. There has also been founded an Oregon Homeopathic Medical College, which soon also ceased to exist. There is no record that either medical college graduated any MDs.
And, I now have in hand two pieces with conflicting information about the year in which Dr. Mae Cardwell joined the Society, becoming the first woman physician to do so. (One source says 1892, this source 1902). Contradictory information is certainly not unusual in historical documents, but frustrating nonetheless. And if Robins' date turns out to be incorrect, we can't expect contrition on his part: the title page carries the disclaimer "all the errors are of his [the author's] own making but no apologies are given."

Following the main history is an 11-page index providing short histories of hospitals in the Multnomah area, including (take a deep breath now):
the hospital at Ft. Vancouver, St. Joseph's Hospital (Vancouver), Oregon Insane Hospital; Multnomah County Hospital; St. Vincent Hospital; Good Samaritan Hospital; Women's Hospital and Sanitarium; Portland Eye, Ear, Nose and Throat Hospital; the Methodist hospital affiliated with the Willamette University Medical Department in Portland (which remained nameless); Homeopathic Hospital, later called Hahnemann Hospital, then called Holladay Park; the Veterans Administration Medical Center; Shriner's Hospital for Crippled Children; Doernbecher Memorial Hospital; Portland Adventist Hospital and Medical Center; Physicians and Surgeons Hospital (previously called North Pacific Sanitarium, Portland Surgical, Coffey Clinic and Hospital, and Coffey Memorial Hospital); Emanuel Hospital; Wildwood Nursing Home, which became the Gresham General Hospital; Eastmoreland General Hospital; Pacific Gateway Hospital (which started as the Sellwood General Hospital and became the Portland General Hospital before changing its name a third time); Bess Kaiser Hospital; and Providence Hospital.

This section should be a great starting point for unraveling the mystery surrounding many of these early hospitals: since the name-change game was so popular, it's nice to have a single source which quickly traces some of the early morphing. Now, if only he'd included maps, too...

Thursday, March 27, 2008

Preservation Needs Assessment site visit underway!

Today, we have been joined by Laura Hortz Stanton, Director of Preservation Services at the Conservation Center for Art and Historic Artifacts, who is on site conducting a preservation needs assessment of Historical Collections & Archives.

What is a preservation needs assessment? Well, as Laura herself pointed out, it's sometimes just a matter of having someone outside your institution write a report about what you and other staffers at your repository already know. In our case, we're hoping that the assessment will confirm our need for more space, better environmental controls on some of our existing spaces, and funding for preservation supplies and specific projects.

From the CCAHA's call for applicants:
The preservation needs assessment process encompasses a general evaluation of the institution’s preservation needs for their collection: environment (temperature, relative humidity, pollution and light), housekeeping, pest control, fire protection, security, and disaster preparedness; collection storage, handling, exhibition, and treatment; and preservation planning. The site visit consists of a review of the site, an examination of the collection, and interviews with relevant staff. The written report provides observations, recommendations, and resources to serve as a guide in the development of a comprehensive preservation plan for the collection.
In fact, we have already learned something new: Laura's light meter recorded levels close to zero near the rare book shelves in the History of Medicine Room, and the levels in the main area are also remarkably low. Only near the windows do the levels rise significantly. This was fantastic news to us, and inevitably not the first positive outcome from this site visit.

Our thanks to CCAHA for awarding us this grant, and hucking all the way on out to Portland (where it is actually snowing today) from sunny, mild, Philadelphia.

Wednesday, March 26, 2008

Project Health: highlighting the age-old dilemma of universal health care

An eight-page oversize pamphlet (maddeningly printed crookedly on some pages) entitled Project Health gives a consumer-oriented overview of a health care delivery system overhaul proposed by Multnomah County in 1973. A longer document on the plan, also from 1973, and an update from 1981 are also available in the PNW Archives collection.

The consumer version of the plan is filled with color and graphics, to help elucidate the complex problem of universal coverage to the average man on the street. One chart even uses smiley faces and frowny faces to show the reactions of various stakeholders to different courses of action (or inaction):

The first goal of the Project--to "develop an alternative to the present system of providing hospitalization for the poor at Multnomah County Hospital"--was resolved a few short years later, when the County Hospital was sold to the State and University for $1.00. The solution to the second goal--to "develop a plan which would give comprehensive health care to the poor"--has proven far more elusive.

An inadvertent foreshadowing of the "mystery" of how to solve the health care crisis comes in another graphic, where doctors reviewing the services are portrayed as the Sherlock Holmes's of the health care equation:

It is a mystery that continues to beguile health care systems and practitioners: how to manage costs, providing the greatest benefit to the largest number of people. Are expensive life-saving interventions always necessary, or even desirable? What are the ethics of managed care which denies expensive treatment to some in order to provide preventive treatments to potentially thousands of others?

In her 1993 book The Healer's Tale: Transforming Medicine and Culture, Sharon Kaufman talks about medicine's current focus on means over ends, and finds that the fascination with technological advances has created new cultural tensions over age-old questions like "What is motherhood?", "What is death?", and "When does life begin?" Her book focuses on the life stories of seven physicians, in an effort to get at the heart of the crisis.

We haven't solved it yet, so our group of Dr. Holmes's have their work cut out for them.

Tuesday, March 25, 2008

No Open Hours This Week (3/27/08)

Quick programming note: the History of Medicine Room will NOT be open for its regular walk-in hours this Thursday, March 27, as we have both been called out to meetings. We apologize for any inconvenience this may cause, and as always are more than happy to set up appointments for other days during the week.

Pre-1901 and Post-1901: a tale of two environments

Here in Historical Collections & Archives, we have several book collections. The History of Medicine Collection, as some of you know, contains books published 1901 and earlier, along with a very few later works deemed too valuable for the main collections.

Books published after 1901 are housed with the circulating collections. For materials published prior to 1985, this means off-site storage. A lovely facility located in the floodplain of the Willamette River, it is neither temperature nor humidity controlled, nor is it equipped with cable or wireless Internet access, nor is it site of a restroom. But these features aside, it's a big space filled with treasures from the first three-quarters of the 20th century.

This week, a small group of librarians began the (occasional) task of going through each and every one of these approximately 35,000 volumes to assess condition, verify holdings, and remove potentially damaging materials (mold is a definite no-no in an environmentally uncontrolled space).

I am one of the lucky few on this crew. And I always have my eyes peeled for gems.

Day One discoveries:
I was able to rescue a partial set of Wilhelm Wundt's Völkerpsychologie : eine untersuchung der entwicklungsgesetze von sprache, mythus und sitte, because the first volume OHSU holds was printed in 1900. Elevation to the elect! The two Wundt volumes now sit in the History of Medicine Room next to Samuel Worcester.

I also claimed the pamphlet "The Authentic History of the Development of Nervous Surgery" for our Pacific Northwest Archives Collection. A satirical look at the history of neurosurgery written by Portland's second neurosurgeon John Raaf, M.D. (under the pseudonym "The Rafiniskis"), the pamphlet sheds some interesting light on neurosurgery in the 1950s--and almost no light whatsoever on the actual history of neurosurgery. A typical text-and-image pairing from the booklet:

In his coda, Raaf quotes Hippocrates: "An important phase of medicine is the ability to appraise the literature correctly." Tongue firmly in cheek, he does excuse himself for errors up front in the preface:
Often only fragments of the picture were found so that some reconstruction and retouching have been necessary to the restoration of these pictures. We trust you will be tolerant of our efforts. If we have allowed ourselves to dream and have not in all instances reconstructed with fidelity the clothes of the individual or placed him in his true environment -- well, such are the effects of the weed, marijuana.

Monday, March 24, 2008

Workshop report, and, What's on the New Books Shelf

A little something for everyone today, both library/archives/museum practitioners and medical history buffs who couldn't care less about the inner workings of repositories.

First up: What's New on the New Books Shelf.
The OHSU Library has just cataloged two new titles of potential interest to you history of medicine fans out there. Post mortem : solving history's great medical mysteries by Philip A. Mackowiak (American College of Physicians, c2007), is a great contribution to the history of "Diseases of the Famous"--sometimes referred to as "Was Napoleon Murdered?" or "Who Is Buried in Grant's Tomb?" (maybe that's another topic--but you get the idea). Actually, there are more and better teasers in the book blurb itself:
Their lives changed history. Their deaths were mysteries, until now! Post-Mortem: Solving History's Great Medical Mysteries by Philip A. Mackowiak, MD, FACP, examines the controversial lives and deaths of 12 famous men and women. Post-Mortem answers vexing questions such as: Was Alexander the Great a victim of West Nile virus? What caused the gruesome final illness of King Herod? Was Joan of Arc mentally ill during her heresy trial? Could syphillis have made Beethoven deaf? Did Edgar Allan Poe drink himself to death? This new book also investigates the mysterious deaths of the Egyptian Pharaoh Akhenaten, the Greek statesman and general Pericles, the Roman Emperor Claudius, Christopher Columbus, Mozart, Florence Nightingale, and Booker T. Washington. Post-Mortem traces 3,500 years of medical history from the perspective of what contemporary physicians thought about the diseases of their renowned patients and how they might have treated them. It follows the case history format of today's clinical pathologic conferences, describing the characteristics of the illnesses in question, and bringing to life the medical history, social history, family history, and physical examination of their famous victims. Post-Mortem then sifts through the medical evidence, testing a wide range of diagnostic theories against the known facts and today's best scientific research, to arrive at the diagnosis most consistent with the illness described in the historic record.
The second interesting medical history title on today's new books shelf is Home visits : a return to the classical role of the physician by geriatrician Alfred E. Stillman (Radcliffe, c2007). Stillman, who is also co-founder of the Philadelphia-based Home Visit Doctors, records his experiences in caring for frail and elderly patients who simply cannot make it to doctors' offices--and who cannot get most doctors to come to them. A throwback to the early years of the twentieth century, the home visit is on the rise in some areas; Stillman's book can aid in studies comparing this "new" phenomenon with its early history.

Topic #2: Streaming Audio and SMIL for Oral Histories Workshop short report.
My first and most substantive comment is this: for those who curate oral history collections, collect oral histories, or think they might someday have to care for oral history materials in their collections, this workshop is a fantastic resource for learning about digital preservation and presentation of the audio and its corresponding transcript (if available). For video, Trevor Bond recommends outsourcing--unless you really want to invest in the technology and the staff resources. For most smaller repositories out there, this is surely excellent advice.

The really good news from Friday's workshop is that, for audio streaming and podcasting, it's really not that hard anymore. Many tools have come onto the market, including some free options, that make web presentation of audio feasible even for very small institutions. Some of the class was spent on discussions of digital audio best practices; for ongoing oral history projects, it's clear that quality recording at the point of creation leads to quality audio files for presentation. For legacy audio, there are programs to help with sound editing; removal of scratches and taps will become a matter of policy (how faithful should we be to the original recordings?) rather than one of technical feasibility.

At the end of the day, as we were getting a little punchy, Trevor took us on a tour of some oral history web sites, to apply "best practice" standards in reviewing design and accessibility. For those interested in a little visual inspiration, check out Historical Voices, a great compendium of sites utilizing audio files in web presentations.

I know I've been inspired, and I already have a pilot project in mind (so it's a good thing the Web Manager went with me!)....