Friday, 26 August 2016

Happy Birthday Professor Dott!

     Today would have been the birthday of the great neurosurgeon Norman Dott, born exactly 119 years ago on the 26th of August 1897 in Colinton, near Edinburgh. His work was crucial to the development of neurosurgery in Scotland; indeed he devised many advanced diagnosis techniques and performed pioneering surgical procedures. Plenty of examples can be found in the c. 28,000 case notes being catalogued under the project “Cataloguing Norman Dott's neurosurgical case notes (1920-1960)” – read more about the advancement of the project here. His collection contains a wealth of fascinating case summaries, drawings and photographs; however on this occasion I would like to present the man himself. We already have written about his life, but this article will try to give a glimpse of the man’s admirable character, especially in his relationship with his patients.   

Photograph of Norman Dott. (PR1.1536)

     Norman Dott was a very well-known and appreciated figure in his city. His colleagues recognised the excellence of his work and his patients were proud to have been treated by him. He would often leave a lasting impression on people, and when a biography was tentatively mooted 15 years after his death, countless letters and phone calls from people who had met him in person poured in. Some of the features that stand out the most are his kindness towards his patients and his sincere interest in them. It is clear when one reads his case notes that Norman Dott really sought to know his patients, their work, their family, their fears and their aspirations. He would take the time to explain to them the nature of their conditions, the treatments available to them, or what they could expect in the future. We can quote here the letter of a father who had arranged for his son, who suffered from a ‘slow mental development’, to be seen by Dott through a common friend: 

      ‘Mrs … and I do… deeply appreciate the courtesy and kindness you have shown us in reading and commenting on my notes in spite of the informal manner of the approach to you, for this matter … is naturally one of the gravest anxiety to us’;

     ‘Again with many thanks for your kindly interest which in itself has been of considerable comfort to us’.

     The parents of this little boy were far from the only ones to express their gratitude to Norman Dott: indeed, it is not rare at all to find in the case notes letters sent by the patients to thank him, postcards greeting him for Christmas or New Year’s Eve, or even photographs of themselves or their child in good health after having been treated by him…Some patients would sometimes keep contact for many years. Norman Dott would always find time in his very busy schedule to personally reply to each of them, with kind words and a personalised attention.

Some photographs in Norman Dott case notes are more lighthearted than others...This child was seen by Dott in the late 30s. (PR4.14380)

A New Year card sent by a patient to thank Norman Dott for his care, with a wee poem! (PR2.1968)

     The correspondence and comments found in the case notes depict a man of great talent and of great compassion, determined to fight disease and always concerned for his patients’ well-being on the short and long term. Even when a treatment was unsuccessful, he wasn’t discouraged and always tried to learn from failure. In a letter relating to the case of a man suffering from a malignant astrocytoma who died despite having undergone an operation, he writes: ‘We shall continue to fight the disease that took him away. At present we cannot cure it: but I have lived long enough to see many diseases that appeared irremediable 10 and 20 years ago come with the score of cure. We shall not forget [name of the patient] nor his malady’. (PR4.19968)

Norman Dott was no doubt a remarkable man, both for his talent as a surgeon and for his humanity and kindness. Happy Birthday Mr Dott!


sources

Rush, C., and Shaw, J. (1990) With Sharp Compassion, Aberdeen: Aberdeen University Press, p.176-216.

LHSA collection, LHB1/CC24/PR.2 and LHB1/CC22/CC4 

Friday, 19 August 2016

Exhibiting archives

This week’s blog is a shameless plug for a couple of fabulous exhibitions in Edinburgh University Main Library…

We have not one, but two, displays over the next few months that concentrate on the display of archive collections. It can be difficult to create a visual feast of an exhibition that is based around archival material – so much of it is loose sheet material that there’s often a lot of beige and printed text! But with some high quality collections and lashings of imaginative design we have two stunning exhibitions that showcase collections held here in the Centre for Research Collections.

The first is ‘Godfrey Thomson: the man who tested Scotland’s IQ’, the University’s Fringe Festival exhibition for 2016. Open from Monday – Saturday, 10am – 5pm (free entry) in the ground floor Exhibition Gallery, this display highlights the life and career of a remarkable man; Thomson was the largest-scale producer of IQ tests in Europe, testing the intelligence of every 11-year-old in Scotland in 1932 and 1947. Professor Ian Deary and his team have gone on to draw on that data to look at how childhood intelligence relates to intelligence and health in old age. Although no LHSA material is in the exhibition, we have been able to contribute to Professor Deary’s research by providing birth weight information for those participants in his Lothian Birth Cohort. For more information about this research please see http://bit.ly/2b5UaXP, and http://bit.ly/2b5ugpQ for the details of the exhibition.
Inside 'Godfrey Thomson: the man who tested Scotland's IQ'
The second exhibition is in the Binks Display Wall on the 6th floor of the Main Library. ‘Enhance, Access and Understand: the University of Edinburgh and the Wellcome Trust’ looks at seven of the Centre for Research Collections’ recent projects funded by the Wellcome’s Research Resources programme. The display shows the diverse nature of the collections whilst also highlighting the specialist archive and conservation skills required to realise the projects. Here you can view examples from our UNESCO-recognised HIV/AIDS collections, and see how storage methods have been devised to meet their long-term preservation needs. Our work to catalogue case notes also features along with the cataloguing of Godfrey Thomson’s own archive, which can been seen in the flesh in the exhibition five floors down! Like the Exhibition Gallery display, it is free but opening times are slightly different: Monday – Friday 9am – 5pm until 31 October.


Two views of the Binks' Display Wall exhibition - featuring Norman Dott on the steps and an early method of treating respiratory disease: a Nelson's Inhaler.
We are running a series of talks alongside ‘Enhance, Access and Understand’. Tickets are free but bookable via Eventbrite. Information on all the talks on offer can be found here: http://www.ed.ac.uk/information-services/library-museum-gallery/crc/events-exhibitions/events
Hope to see you there!

Friday, 12 August 2016

War hospital women

This week, Louise concludes her series of blogs on the role of women in medicine in our region during the First World War. Her last blog looked at women serving on foreign battlefields, but she has discovered that a posting in one of Edinburgh’s military hospitals brought experiences mentally (and sometimes physically!) far from home too:

For the nursing staff of Scottish military hospitals during the First World War, there were many rude awakenings. For professional, hospital-trained nurses, the influx of casualties must have been a shock, along with the injuries that came as a result of mechanised warfare on a mass scale. Some hospitals specialised in the horrific injuries that trench warfare brought, such as Edenhall Hospital for Limbless Sailors and Soldiers (sited at Pinkieburn, Musselburgh from early 1918). Edenhall developed and made mobility aids onsite - you can see some at the front of this photo:


Patients and staff at Edenhall, c. 1917,(Acc 12/054)
For volunteer nurses drafted in for wartime needs (Voluntary Aid Detachment nurses trained by the Red Cross in basic skills – VADs), the comparisons with life before the war must have been even more stark. Not only did most women enter the working world for the first time and lived away from the family home, but they were also exposed to the male-dominated life of the ward, with bodies, blood and bone becoming commonplace sights for them.

But serving in a Scottish military hospital did not necessarily mean seeing out the war on the home front. Having gained experience in caring for soldiers at home, nurses, doctors and orderlies from hospitals around Edinburgh were called to serve abroad. For staff at the 2nd General Hospital, Craigleith, this sometimes meant serving in the Mediterranean Expeditionary Force in North Africa. Here are Territorial Force Nursing Service (TFNS) nurses and Royal Army Medical Corps members taking time away from duty at the pyramids in Egypt in a photograph sent back to be published in the hospital magazine, the Craigleith Hospital Chronicle:

Craigleith staff in Egypt, 1916 (GD1/82/12)
TFNS nurses were professionally training nursing staff, who volunteered to care for the wartime territorial forces (that is, those who volunteered to fight rather than professional soldiers). I think that that these particular nurses are TFNS nurses (rather than VADs) on account of their uniforms. There’s more on military nursing uniforms on the excellent Scarlet Finders site, here

Camels in Egypt were not just for fun. In 1916, a Scottish medic serving in the military hospitals sent the Craigleith Hospital Chronicle this article:

Article heading, 1917 (GD28/6)
The author mentions the very important transport roles that camels played in military life, and the need for regular rest from the punishing life of a working animal:

“They are being used in thousands as transport to carry food, ammunition etc…Within five minutes walk of my home… there is an enormous rest camp where they get treatment, food and rest…. In the Camp there is a dipping tank like those used in Scotland for dipping sheep…”

The end of the war did not bring respite for the hardworking nurses of the 2nd General Hospital, Craigleith, who were to have one last adventure – sailing from Leith to Danzig to bring back sick and wounded prisoners of war. Again from the Craigleith Hospital Chronicle, we learn that a nursing sister and three staff nurses spent a total of eight weeks on board their ship, the Western Australia, during December 1918 and January 1919:

Article illustration and caption, 1919 (GD28/6)
They witnessed the relief at war’s end, and saw the results of its horrific effects, as this quotation shows – which must have been quite a shock for these middle-class women, even if they were hardened by their military hospital experiences:

“Next day we see Russian prisoners being transferred from barges to ships with Waffenstillstand and Armistice painted on them. We see the Russians scraping the decks and winches with their knives for fat, and eating it.”  Staff-Nurse E D Robertson


The article also mentions events that would shape the world to come. For example, Nurse Robertson reports that different attempts to evacuate British former prisoners of war from Germany were hampered by the start of the 1918 November Revolution (which would eventually lead to the Weimar Republic).

One of the strongest things that you see in the Craigleith Hospital Chronicle is how life must have changed for women as a result of their wartime experiences. We often think of auxiliaries in terms of the Second World War, but this poem shows that women played a crucial support role from 1914 to 1918 for the Army (WAACs), Navy (Wrens) and Women’s Royal Air Force (Penguins  - because they did not fly!):

Craigleith Hospital Chronicle poem, 1918 (GD28/6)
And this advertisement for insurance for the ‘income earning woman’ simply would not have existed before the war:

Craigleith Hospital Chronicle advertisement, 1918 (GD28/6)
The lighthearted humour in the Chronicle also reveals more than it may have originally intended. Times were changing for women just as they were coming into the workplace in great numbers out of the necessity of warfare. This cartoon, although undoubtedly in poor taste, hints at this change, as well as displaying not a little bit of apprehension at a world that looked to be turning upside down. It reads:

"PTE. MURPHY (who is to be kept without food for 24 hours), as Nurse passes him: 'Shure, Nurse, dear, I hope they don't think I'm a Suffragette.' "

Craigleith Hospital Chronicle cartoon, 1918 (GD28/6)ption

Friday, 5 August 2016

TB, the BCG, and the RVD

This week, our Project Cataloguing Archivist Rebecca looks at the development of the BCG vaccination and its introduction to Edinburgh:

I’m sure many of you will have the distinctive scar on your arm from the BCG [Bacille Calmette-Guérin] vaccination, which protects against tuberculosis [TB]. The vaccination works by injecting one with a weakened form of tuberculosis, so that the body is able to recognise and defend against the bacteria if one comes in contact with the disease.

A BCG poster on display as part of a public health exhibition, c. 1952. [P/PL16]
It is named for the men who developed it, Albert Calmette and Camille Guérin; they began their work in Lille in 1900, and worked throughout the German occupation of the city during World War I to create a weakened form of tuberculosis bacteria which wouldn’t cause infection when injected into animals. In 1921 the vaccine was ready for testing on humans, and was first administered orally to an infant whose mother had died from tuberculosis; by 1924, 664 infants had been vaccinated with BCG, and in the next four years 114,000 infants were vaccinated without serious complications. The vaccine was taken up in various European countries, but British doctors remained sceptical of its effectiveness, and in the US there were some concerns over the safety of the vaccine.

These concerns came to a head with the Lübeck disaster in 1930, in which a scheme to vaccinate 250 newborn infants led to 73 deaths and 135 infections of tuberculosis after a contaminated vaccine was used; though the BCG itself was not the cause of the disaster, confidence in it dropped considerably. However, when tuberculosis became a major public health concern in the aftermath of World War II, which led to renewed vigour in attempts to find a cure. Trials of BCG carried out in the UK at this time showed that the vaccine was highly effective when given to children who had not previously been infected with tuberculosis, leading to its adoption in this country.
Case notes from the Royal Victoria Dispensary, 1950, [LHB41/CC/2/PR2] , showing: (L-R)
A record that the patient was vaccinated and subsequent positive Mantoux tests, a form consenting to vaccination, and a negative and a positive Mantoux test result.

From around 1950, the Royal Victoria Dispensary [RVD] gave BCG vaccinations to children and young adults who were in close contact with a tuberculosis sufferers. A Mantoux test was given to all attendees of the clinic in order to determine if they had already been exposed to TB bacteria. If a young patient had a negative response to the Mantoux test, indicating that hadn’t been infected already, they would be given the vaccination in order to protect them against catching the disease in the future.

The 1949-1950 Annual Report of the Royal Victoria Tuberculosis Trust shows the optimism that the success of the vaccine brought to the community, proclaiming that “[t]he tuberculosis BCG vaccine has been accepted as being of value in stimulating immunity, and its increasing use among those approaching puberty who have not already come successfully through a tuberculous infection will prevent much of the morbidity and mortality of that period of life.” In this spirit, from the mid-1950s the UK introduced the routine vaccinations of school children, which continued until its replacement with a more targeted programme of vaccination in 2005.

A girl receives a BCG vaccination, 1953 [LHB16/38/21]
 
Sources:

LHB41/7/1 Annual Report, 1949-1950
LHB41/CC/2/PR2
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749764/
http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx
http://patient.info/doctor/bcg-vaccination

Friday, 29 July 2016

From the Norman Dott collection to the TB case notes...

     Six months have passed since I started my contract as a cataloguing archivist for the Norman Dott project and after cataloguing 4308 case notes, it is time for me to move on to another project involving medical records: ‘RVH v TB’, a project to catalogue LHSA’s Royal Victoria Hospital tuberculosis and diseases of the chest case notes and registers (c.1920-2000). I will be working alongside Becky and later Clair to catalogue the 25,000 cases files from the Royal Victoria Tuberculosis Trust and associated hospitals. 

Boxes containing the LHB41 CC/4 series.

     Last Monday I started working on the series LHB41 CC/4, which is composed of 71 boxes of case files from the Royal Victoria Dispensary for Diseases, plus 6 boxes of X-ray films and 6 boxes of miscellaneous papers. My target is to catalogue 40 case notes a day on the xml editor Oxygen. The transition from one project to another has been facilitated by the fact that the methodology used for cataloguing the tuberculosis (TB) case notes is based on the one created for the Norman Dott records. They contain the same kinds of documents, from roughly the same period: case summaries, correspondence, notes, charts, medical reports, sometimes X-rays, and forms and contact sheets. I record the same type of information: age, sex, geographical origin and name of the patient, medical conditions and symptoms, date at examination, covering dates, type of treatment given, and outcome for the patient. However, there are some differences between the Norman Dott case notes and the TB case notes – beyond the fact that pulmonary tuberculosis, pneumonia and bronchitis have now replaced brain aneurysms, cerebral tumours and head injuries.

An example of case note from the TB collection. PR4.72 (all personal details have been redacted)

     One of the most important differences is the fact that tuberculosis was a highly infectious disease, unlike most of the conditions in the Norman Dott records. The methodology created for the Dott project has been adapted to reflect this particularity: for example, the way locations are recorded in the RVH v TB project is slightly different. Most patients come from Edinburgh itself, so it was decided to use Westminster constituencies to locate the patients: it is precise enough to give an idea of the spread of the disease without risking disclosing the identity of an individual. We also record the family history of tuberculosis, indicating whether a member of the patient’s family had had tuberculosis or not. Tuberculosis was a matter of public health, and public authorities made everything in their power to stop the spread of the disease. It included keeping track of all the persons who had been in contact with an infected patient, mainly their family but also their landlord and neighbours when applicable. The persons deemed at risk were then called for examination; that’s why the case files sometimes contain contact sheets detailing the examination of the relatives of a patient suffering from TB. In these circumstances, children were often given the BCG vaccine (that is to say the Bacillus Calmette-Guérin vaccine, against tuberculosis).

     The Royal Victoria Dispensary case notes promise to be as fascinating as the Norman Dott records, with their own particularities and challenges. I am looking forward to learning more about the history of tuberculosis in Edinburgh and helping project cataloguing archivist Becky to complete the cataloguing of this impressive collection.  


Aline Brodin, project cataloguing archivist. 

Friday, 22 July 2016

Let's get digital...

For many heritage institutions, digitisation can a bit of a double-edged sword, and the question “why don’t you just put it all online?” has been known to cause a bit of eye-rolling and clenched fists amongst archivists. In this week's blog Alice considers the issues that surround digitisation, and introduces an exciting project that LHSA is involved in...

As much as many of us would love to digitise large parts of our holdings, there are practical issues that can stand in the way. Digitisation involves more than simply snapping away with a hand-held camera: to be a worthwhile endeavour, it should produce high-quality digital images that can then be used in a variety of ways. In order to capture such images, you need good equipment, and this can be expensive! Another option is to outsource the services of a good digitisation company, but again, the costs can rise and rise. When beginning a digitisation project, it’s important to consider what is within the means of your institution.

Another concern is what the material you’re looking to digitise can withstand in terms of the photographic or scanning process. With many older volumes, the bindings might make it difficult to produce a ‘flat’ image, as they can cause the pages to curve out of shape. Although a flat image is needed, care must be taken to minimise the amount of stress placed on the most vulnerable areas, and this might require the use of specially designed cradles to hold the volume. Some volumes might be robust enough to go through a scanner which automatically turns pages as it goes – for others, the delicate nature of the pages means this is out of the question. Similarly, exposure to high light levels can have damaging effects on some records, and it’s therefore important to have a carefully-monitored lighting set-up.
The binding of the volume has here caused the pages to 'curve', making capture difficult.
A further concern is about not the physical form of the records, but their actual content. Many of LHSA’s records concern individuals, and as we’ve discussed before, it’s very important that we bear in mind potential issues around privacy and sensitivity when providing access to these records. In a similar vein, it’s also important to consider how any digital surrogates of a record might be used in the future, and how far we are able to control this. While digitisation allows for new contexts to be brought to records, we have to be sure that these new contexts build on, rather than obscure, the original context of the records’ creation.

A recent digitisation venture that LHSA has recently been involved with is the Florence Nightingale Digitisation Project, hosted by Boston University’s Howard Gotlieb Archival Research Centre.  The project aims to create a comprehensive database of digitised correspondence written by the pioneering nurse, and so far they have been able to provide access to over 1900 items.
LHB1/111/3 - Bound volume of letters presented to the
Royal Infirmary of Edinburgh by Miss Angelique Lucille Pringle
Past readers of our blog will remember that we hold a volume of letters written by Nightingale. These were presented to the Royal Infirmary of Edinburgh in 1951 by Miss Angelique Lucille Pringle, who had trained under Nightingale. The two women established a long friendship, and in her letters Nightingale refers to the younger woman as ‘Little Sister’, a nickname bestowed on her for her short stature and kindly temperament.

As part of our contribution to the Florence Nightingale Digitisation Project, we’ve been looking at how to best go about preparing this, and the staff of the University of Edinburgh’s Digital Imaging Unit have been on hand to provide us with guidance. The volume is a tricky one – almost every page is a different size, and there are a number of sections where Miss Pringle has clipped out confidential or private details from the letters, meaning they don’t always ‘sit’ on the page in the order you might expect! Many of these pages are very delicate, and there are one or two where Nightingale has added corrections or clarifications in pencil to a typed letter. This means lighting levels have to be absolutely perfect in order to pick up all these small details without accidently picking up the typed text on the reverse of the page.


One of these letters is already digitised - you can see this in full over on our issuu page – and we’ll be adding more details here as the project progresses. It’s great to see such a wonderful resource for Florence Nightingale enthusiasts coming together, and even better that LHSA is able to contribute to it!

_____

Resources:
  • This video from the University of Oxford is a great introduction to how digitisation can open up records to new audiences
  • Find out more about the University of Edinburgh's Digital Imaging Unit and the work they do at their blog

Friday, 15 July 2016

Downton Abbey and fortune telling fish...



Around this time last year, Ruth helped deliver a training day on collection care basics. It was held in London and the teaching was shared with a Preventive Conservator colleague from the British Library, where the course was held. Earlier this month Ruth was back at the British Library to provide this ‘Essential Preservation’ training day to a fresh group of attendees….but how were one of the nation’s favourite TV shows and a Christmas cracker toy involved?

Last year’s ‘Essential Preservation’ training session had been a great success – library and archive professionals who were interested in learning more about the steps they might take to care for their collections spent the day looking at a range of issues from best practice handling to writing preservation policies. The feedback was good but I felt that some improvements could be made to make it even better!

The day was split up into six sessions: an introduction setting out terminology and referencing the relevant standards and then lectures on handling, storage, writing a preservation policy, risk management and disaster response, and finally communicating the conservation message and where collaborations and sources of help can be found. I was responsible for three of the sessions – handling, storage and policy writing.

There’s so much important information to pass on that it was difficult of think of any other way to convey it other than in a lecture format. But the first time I ran the sessions I felt that the PowerPoints I had produced were a bit text heavy and would benefit from some more pictures to illustrate my points, and that there needed to be a bit more participation from those attending to make it more engaging for them.

The handling session already had a strong practical element in the shape of demonstrations and the opportunity for delegates to have a go at applying best practice techniques themselves; and in the policy session I had a short practical exercise to start everyone thinking about what their own preservation policy might contain. So I concentrated on how to improve the storage session...

In this part of the ‘Essential Preservation’ day I was looking at the various different factors that can impact on the condition of collections while they’re in storage, from the structure of the building itself through to the environment in the stores and the shelving and boxing used. I also looked at the kind of maintenance programmes needed to keep high quality storage spaces, including putting a robust housekeeping regime of cleaning and monitoring in place. And this is where Downton Abbey came in – who better to illustrate the need for cleanliness than the redoubtable Mrs Hughes, the housekeeper in Downton Abbey, who now adorns one of my PowerPoint slides along with Mrs Doyle and Kim and Aggie!


I also wanted to introduce an exercise for the delegates so they had a chance to put the principles I covered into practice. With the help of a colleague who used to work for the National Trust for Scotland, we created graphs showing temperature and relative humidity over the course of one day for three fictional spaces – a conservation studio, a store built to the sector standard, PD5454:2012, and a room in a historic house. The delegates had to work out which graph related to which space and then discuss the conditions shown in the graph – were they suitable for collections, and were there any measures they would introduce to improve conditions? The exercise seemed to work really well, it certainly got everyone talking about collection care issues, and I think we could have expanded on this a bit more if it hadn’t then been lunchtime!

I promised fortune telling fish… well, everyone got one when I was describing the potential issues around relative humidity as an example of how warmth and moisture in the air (or in this case from your hand) can impact on materials in your collection. 


According to the fish, I’m fickle!