Plastic Fantastic?! Conservation of Modern Objects in the HIV/AIDS Collections

This week our project conservator, Emily Hick, discusses the problems with plastics in archival collections:

Over the past five weeks I have been working on one part of the HIV/AIDS collections which documents the ‘Take Care’ Campaign in Edinburgh and the Lothians. This campaign began in the late 1980s and aimed to raise awareness among all members of the community about the causes of HIV/AIDS and also to promote safer sex with the message “take care of the one you love”. This was achieved through high profile events and gigs, as well as educational programmes and providing free sexual health advice and condoms. This diverse collection contains a wide range of materials; from modern paper materials such as reports, educational packs and administrative files to plastic audio visual objects and modern rubber/latex items such as balloons and condoms.

Many people assume that modern collections such as this do not require conservation, however this is not the case, and there are already items in this collection that are severely degraded. For example, balloon 1 in the photograph below has degraded and become extremely brittle, resulting in it becoming fragmented when flexed during storage. The conservation of modern plastic materials is complex as although the objects may look similar, they may not be formed of the same materials and depending on the original composition of the plastic object, it can degrade in different ways. For example, these four balloons (1 – 4) were stored together in the same environment, but have degraded in completely different ways. Balloon 1 has become brittle and fragmented, balloon 2 has become tacky and stuck to a business card it was stored with, balloon 3 has hardened and balloon 4 is still relatively flexible.

Four balloons stored in the same environment that have degraded in different ways

 

Deterioration of plastics such as this can be caused by either chemical or physical factors. Chemical degradation can be caused by the interaction of plastics with light, heat, oxygen or water. These factors provide the energy and the environment to promote destructive chemical processes. Physical factors include degradation caused handling of the object, for example the incorrect handling and repeated bending of a plastic doll may result in stress fractures or breakages. Physical degradation can also be caused by the migration of additives from the plastic object. Plastics contain additives called plasticizers that increase the flexibility of the object. However as the object ages, the plasticizers evaporate causing it to become more brittle, which has occured in balloon 1. This can be particularly problematic if the plasticizers are absorbed by another material in close contact with the object. The photograph below shows a window sticker that has degraded, releasing plasticizers which have in turn been absorbed by the plastic pocket it was previously stored in, resulting in deformation of the pocket.  

Plasticizers released by the window sticker have been absorbed by the plastic pocket causing it to deform

Plastics objects not only form part of this collection, but plastics such as ring binders and poly-pockets are also used to store many paper materials. These materials also degrade and can adversely affect the papers contained within them. Store-bought ring binders can be especially problematic for archival collections as they are commonly formed from PVC (polyvinylchloride). This type of plastic emits hydrochloric acid over time which can be readily absorbed by paper materials and cause them to degrade. As such all paper materials have been removed from these folders, but reference samples have been kept separately so that the original look and function of the materials can be recreated if necessary.

The conservation of the plastic items in the collections has particularly caught my interest as this is a subject area that I had little prior knowledge of and did not expect to be treating when I qualified as a paper conservator! The production of plastics has risen dramatically over the past 50 years, from 5 million tonnes in the 1950s to almost 100 million tonnes in early 2000. In 1982, the production of plastic surpassed that of steel and as such that year has been dubbed the beginning of the ‘Plastic Age’. Therefore, the amount of plastics found in archives is growing and although research about this subject matter is relatively small, it is a fascinating area, and I believe that the issues surrounding the conservation of this material will become more important in the future.

Neurosurgery Reconstructing Lives

I am currently four weeks into a ten week cataloguing internship with LHSA working on the Wellcome Trust funded project, Cataloguing Norman Dott’s Neurosurgical Case Notes (1920-1960). During my internship I will be assisting Louise,with cataloguing as well as finding out about the work carried out at LHSA.  The records I will be cataloguing relate to Dott’s work during the Second World War, when he set up the Brain Injuries Unit in Bangour General Emergency Service Hospital in Broxburn, West Lothian.

 

Dott's ward at Bangour, c. 1939

Generally the patients are military personnel; however I have also come across a couple of civilian and private cases. Several patients were sent there suffering from headaches, as Dott was particularly interested in investigating these cases, but reasons for admission were pretty varied and include many cases of head injuries sustained both as a result of military service and whilst off duty. As part of Dott’s role he also had to assess his patient’s capacity for continued military service and give a recommendation as to their grading or discharge. He would also give his recommendation regarding pension eligibility for those soldiers who were to be discharged due to their condition and his opinion as to whether their injury or illness arose or was exacerbated by military service. So far the patients I have come across have been mostly male, although there have been a couple of females who were serving as Volunteers with the Auxiliary Territorial Service.

I have selected an interesting case to share which involved a soldier who received a gunshot wound to the head.  This case is particularly interesting as the patient had a long relationship with the Brain Injuries Unit, lasting 23 years, and the case file contains several different types of material including case notes, correspondence, clinical charts, drawings and photographs. This patient was injured shortly after coming off guard duty when a rifle was accidently fired by a fellow officer. Initially the patient was taken to the Military Hospital at Edinburgh Castle, but was quickly transferred to Bangour. The bullet had fractured his skull, passing through the left frontal region and an operation was performed to remove the loose bone fragments and damaged tissue. This drawing from the case notes shows the passage of the bullet:

 

LHB40 CC/2/PR3.189, patient identifying information redacted

 The patient recovered and was out of bed eight days after the operation; however he was left with a skull defect. A letter from the patient to Dott in 1947 shows the patient was later keen to have something done about it:

 

LHB40 CC/2/PR3.189, patient identifying information redacted

In 1947 he returned to Bangour to have this defect repaired. Rather than the bone graft mentioned in the letter, an acrylic plate was made to reconstruct his damaged skull. This process involved two operations, the first to take a cast and the second to fit an acrylic resin mould. Again, the patient recovered well and it was noted that, ‘the cosmetic result was very satisfactory’. These pictures show the patient’s wound being dressed after the operation, and are two of six found in the case file:

 

LHB40 CC/2/PR3.189, patient identifying information redacted

 

This week we bid farewell to our Archivist, Laura (only for a year though!)

They say that every seven years we undergo significant changes in our lives, and that is certainly true for me today. After nearly 7 years of working at LHSA, I am taking a year’s leave, and moving to Munich where I’ll hopefully have the chance to work in the archives of Ludwig-Maximilian University; for those who can read German (and that doesn’t include me yet!), their website is at: Ludwig Maximilian University Archives. My first job will be to learn German in a month-long intensive course at the Goethe Institut, followed by lots of practising on the poor souls at the University Archives. My year abroad should broaden my perspective of archive management in the wider European context, and give me the chance to learn about a new collection.

Here are some of my highlights of the last seven years at LHSA!

2007: I started as Assistant Archivist on 2 April and was introduced to the joys of cataloguing including the papers of Helen Millar Lowe who helped maintain a female-only medical staff at the Bruntsfield and Elsie Inglis Hospitals in the 1950s.

A cartoon from Helen Millar Lowe's papers

2008: During the summer of 2008, we moved into our new accommodation as the Centre for Research Collections was born. Over 1,000 linear metres of LHSA collection items were moved into their current storage space.

2009: I started the volunteer programme at LHSA; our second volunteer, Louise, is now our Project Archivist! I also helped create posters telling the story of the Royal Edinburgh Hospital in preparation for the bicentenary celebrations; the foundation stone of the Hospital was laid in 1809. You can see them here: Royal Edinburgh Hospital charter posters.

2010: We developed a social media presence for LHSA which included this blog and a Flickr page, shortly followed by our Facebook page. Oh, and our HIV/AIDS collections were added to the UNESCO UK Memory of the World Register!

2011: I led oral history training sessions for students from the Edinburgh College of Art as part of the Unsung Heroes project. The oral testimonies of nurses are now part of the Archive informing our knowledge of twentieth century nursing lives.

Part of the Unsung Heroes exhibition

 2012: I had the privilege of becoming the LHSA Archivist and got to explore more of this wonderful collection as I helped choose exhibits for the Masterpieces III exhibition.

My lovely LHSA colleagues after our traditional Christmas curry, 2012

2013 was a packed year with the Royal Edinburgh Hospital bicentenary, Wellcome Trust bid writing (we got them!), and the opportunity to present talks on our social media to heritage sector colleagues in Edinburgh, Aberdeen and Dublin.

2014 has seen the start of our Wellcome Trust-funded HIV/AIDS project – great to see the fruition of all that bid-writing!

A postcard from our HIV/AIDS collections

Auf Wiedersehen bis 2015 (I really hope that’s right!)

My farewell cake, courtesy of master baker Louise

A look at the Deaconess Hospital

This week, we take a look at the story of the Deaconess Hospital and the records relating to it at LHSA.

In 1888 the Very Rev. Professor A H Charteris proposed to the General Assembly of the Church of Scotland his scheme regarding the organisation of women’s work in the Church. This included the Women’s Guild and the Order of Deaconesses. The scheme was approved and a site purchased in the Pleasance, Edinburgh, to found an institution where Deaconesses could be trained for missionary work at home and abroad.

In 1889, St Ninian’s Mission opened here among the overcrowded tenements of the Pleasance and Cowgate areas, and in 1894 the Deaconess Hospital was opened alongside it. At the Hospital, practical training in nursing was taught to the Deaconesses who spent a year working there. For those who wanted to become fully trained nurses, they could also work for a further three years in the Deaconess Hospital’s Nurses’ Training School. As well as training Deaconesses before setting off on missionary work, the Hospital was a source of free medical care to one of the poorest districts of the City of Edinburgh at that time. A home visiting service of District Nursing and Midwifery was also provided, run by the Staff Nurse in charge. Major reconstruction work was carried out during 1934 - 1936 and the Deaconess Hospital expanded, extending into the old police station and other buildings adjacent to it.
 

SS Irvine Robertson, Matron of the Deaconess Hospital, 1920 - 1927 (LHSA ref. PH3/12)

In 1948, with the formation of the NHS, the Deaconess came under the control of the South Eastern Regional Hospital Board and in 1974 it became part of the South Lothian District of Lothian Health Board. The Hospital finally closed in 1990, though it remained in NHS ownership. The building was re-named Deaconess House and continued to be used as the headquarters of the NHS Board until their move to Waverley Gate in 2010.

  The Hospital, c.1935 (LHSA ref. PH5/57)

LHSA records from the Deaconess Hospital include annual reports, minutes of the many committees which worked there, patient admission records, case notes, nursing and midwifery records, operations books and staff appointment records. These are catalogued under LHSA reference LHB12.

A stage debut…

Last Saturday Ruth took part in a performance of ‘Voices from the Past’ at the Talbot Rice Gallery – a piece written by Alison Stirling from Artlink using the extensive research carried out in LHSA for the Royal Edinburgh Hospital bicentenary, and the ‘200 Years, 200 Objects’ exhibition in particular.

The script was for two, and the first of many parts was played by Pauline Goldsmith, an award-winning actress. She read numerous excerpts from texts in LHSA, along with extracts from oral histories from staff and patients, and some fictional pieces written by Alison to evoke the long history of the Hospital. Each one was delivered in a different accent, with a different tone, to capture all the different people that had a relationship with the Royal Edinburgh over the last 200 years. I had a much easier job, and simply had to read out an introduction and conclusion, and intersperse Pauline’s performance with the date the extract she was reading originated from. It's just as well it didn't require much dramatic flair from me as this was my first performance since treading the boards at school!

Pauline (left) and Ruth (right) at the Talbot Rice Gallery. A slide show of images from LHSA accompanied the performance (far right)

Saturday was the second performance of ‘Voices’. The first saw Pauline and our Archivist Laura delivering Alison’s work to an audience in the Royal Edinburgh itself. Both events were well attended and got excellent reviews! Many felt that ‘Voices’ provided a very accessible insight into the Hospital’s history, and helped them connect with the people in the Royal Edinburgh’s past. Holding the second performance in the Talbot Rice, alongside the ‘200 Years, 200 Objects’ exhibition, really added to ‘Voices’ as the audience could look at the display before and afterwards.

Both images are taken from the Talbot Rice Gallery’s Facebook page, please see https://www.facebook.com/talbotricegallery for more. ‘200 Years, 200 Objects’ will be on display for another week, closing on 15 February. For more information please see the Talbot Rice Gallery website: http://www.ed.ac.uk/about/museums-galleries/talbot-rice/current/everpresentpast.

I thoroughly enjoyed taking part in ‘Voices’ – it is always exciting to see how LHSA material can be used in novel ways to such great effect.

Exciting New Project at LHSA

Thanks to generous funding from the Wellcome Trust, a project is now underway to catalogue and conserve the LHSA’s fantastic HIV/AIDS collection. This week Emily Hick, the new Project Conservator, introduces herself and her new venture:

Three weeks ago, I began a 12 month position as a Project Conservator with the LHSA. I graduated last year from Northumbria University with an M.A. in Fine Art Conservation where I specialised in ‘Works of Art on Paper’ and prior to taking this position I had been working at the Alnwick Castle Archive as a Paper Conservator. Therefore, the type of material found in this collection is quite different from what I have worked with previously, but the conservation principles are the same and I am looking forward to the challenges of working with this modern collection in the coming months. Over the next year I will be blogging about the unique conservation issues that collections such as this pose and how I have treated various aspects of it.

The first suspected case of HIV/AIDS in Scotland was discovered in Edinburgh in 1983. The infection rate in the city steadily grew and by 1989 it was seven times higher than the national average, which led to Edinburgh being dubbed the “AIDS capital of Europe” in the national press. LHSA collected documentation regarding the medical and social response to the disease in Edinburgh and the Lothians and in 2011 the collection was inscribed to the UNESCO UK Memory of the World register, highlighting its importance to national documentary heritage. It is an extremely valuable archive that records the changes in response to HIV/AIDS, from firstly focusing on homosexual transmission and infection through blood transfusions, then transmission between heterosexual partners and finally infection due to the sharing of needles and mother to child transmission. Policies formed at this time, in terms of awareness and prevention campaigns as well as care of patients, went on to inform national policy. Therefore, this is an archive of vital importance which comprehensively documents an important part of medical history.

The collection itself is made up of a variety of media, mostly loose paper documents, but also badges, stickers, photographs, 35 mm slides as well as rubber and latex items such as condoms and balloons. There is also a collection of digital media such as 3.5” floppy disks, VHS, audio cassette tapes and film reels which need to be transferred to modern storage facilities to avoid loss of this data due to deterioration of the object or the obsolescence of viewing equipment. The photograph below show the diversity of objects found in the collection, often stored together in unsuitable housing.

Varied collection of objects found in GD22, an accession which documents the "Take Care" awareness campaign.

 

Despite its importance, only basic preventative conservation methods have been carried out on some of the collection, such as the storing paper documents in archival boxes. So, over the next year I will be rehousing the entire collection and carry out conservation treatments such as surface cleaning, tear repair and flattening where necessary. Since starting three weeks ago I have been very busy; meeting all my colleagues at LHSA and CRC (Centre for Research Collections) and finding out what they do, inductions to the library and getting to know the conservation studio and the collection I will be working with. I have also carried out a detailed survey of the collection and put together a conservation proposal for GD22. This accession contains documents relating to the public awareness ‘Take Care’ Campaign and treatment of this is now well under way. It’s been a great start to the project and I am looking forward to working with this fascinating collection over the next year.

If you would like to find out more about the content of the HIV/AIDS collection, please visit our website: http://www.lhsa.lib.ed.ac.uk/source/HIVAIDS_index.htm

Pioneering practice

This week, Project Archivist Louise traces some of neurosurgeon Norman Dott's breakthroughs in the treatment of aneurysms:

Aneurysms occur when weakness in the walls of veins or arteries cause a ‘bulge’ when blood passes through them. This weakness can produce bleeding, a haemorrhage, when the walls of the vessel rupture. In the field of surgical practice, Norman Dott stands out for his pioneering 1931 operation to treat an intracranial aneurysm by direct surgical intervention into an area called the Circle of Willis, a loop of arteries at the base of the brain. Since these arteries sit near the brainstem, through which the nerves that connect the brain to the motor and sensory systems of the rest of the body pass, operating in this area carried a great deal of potential risk in the early days of  Dott’s ground-breaking surgeries.

This first operation on such an aneurysm was carried out on a middle-aged patient whom Dott described as a ‘personal friend and benefactor’. Dott wrapped the area of the aneurysm with muscle from the patient’s leg in order to strengthen the blood vessel walls where they were thinning dangerously. Weary of seeing patients die from brain haemorrhages, post-mortem observations had led Dott to realise that brain haemorrhages could sometimes heal themselves by blood-clots that stemmed further leakage, and that surgery could perhaps ‘reinforce Nature’s attempt at healing’ through providing another form of ‘scaffolding’. Although he was advised against surgical intervention for fear of fatality (for medical specialisms such as neurosurgery in their relative infancy could ill afford a high mortality rate), Dott proceeded with the operation in April 1931. Despite the risks, the operation was a success, with the patient’s only complaint being a pain in his leg from where the muscle graft was taken!

However, such surgery was a major undertaking and carried considerable risk. For aneurysms of the carotid artery, Dott practised tying (ligation) of arteries, shutting off blood-flow to the aneurysm, a practice that he pioneered in 1932, just a year after his pioneering aneurysm wrapping operation. The process of detecting aneurysms was considerably aided in 1933, when Dott was the first to demonstrate an aneurysm by means of angiography, an x-ray technique that involved operating on the patient under anaesthetic to expose the artery, injecting it with a dye and subsequently taking x-ray films.

LHB1 CC/24/PR2.917 Photographic image of an angiogram clearly showing the blood vessels in the brain (1942)

Yet another breakthrough was to come in the midst of the Second World War, when Dott performed an operation on a foreign seaman. The patient had an aneurysm in the anterior communicating artery, a small vessel which carries blood from one side of the brain to another. It is a common site for aneurysm formation and difficult to access without causing further haemorrhage. In the case of the seaman, Dott decided that it would be safer to put a clip on the larger artery which was feeding the smaller anterior communicating artery – this could be done without disturbing the aneurysm, which had already ruptured. Although the operation itself was not without risk, the patient’s case file reveals that he was ‘up after five days… in excellent condition and fit for discharge.’

Dott’s work in the diagnosis and treatment of intracranial aneurysms was both pioneering and wide-ranging – weighing up the risk to each patient, treatment was advised accordingly. In some cases of aneurysm Dott recognised that the surgical risk (and even the risk of exposing arteries through angiography) was unwarranted when it was possible for the body to repair itself through rest and recuperation.

We are extremely lucky at LHSA in holding a large collection of x-rays and photographs of Dott’s diagnostic procedures – both ventriculograms and angiograms. In the age of Magnetic Resonance Imaging (MRI) and Computerised Tomography (CT) scans, it is easy to forget how invasive these x-ray diagnostic procedures were for patients (operations in themselves), and how privileged visions inside a patient's head could not be taken lightly in these relatively early days of neurosurgery.