Medical Records Revived!

In this week's post, Archivist Louise talks about a very special event taking place today...

This afternoon, we'll be launching the results of our neurosurgery cataloguing project. Not only are we celebrating by holding a public launch, but a case note catalogue will be released online. We've been cataloguing case notes from Edinburgh neurosurgeon Norman Dott since autumn 2012 with funds from the Wellcome Trust and, although we've had some pauses along the way (as staff have changed), it's wonderful to see the effort of all those involved in the project realised. The project could not have been completed without the hard work of cataloguing archivists, staff from LHSA and the Centre For Research Collections, interns, volunteers, University staff, project advisors and the help of the Wellcome Trust Research Resources team.

Cataloguing Norman Dott's Neurosurgical Case Notes (1920-1960) has produced a public, online catalogue to Dott's case notes (which hides patient identities in these mostly-confidential records) and a full catalogue, which includes identifying details and can only be seen in the LHSA reading room by legitimate researchers with special permissions from NHS Lothian. It's the first time that medical case files have been catalogued like this in a UK medical archive (in fact, I can't find a precedent anywhere else in the world!).

The Dott case notes are particularly special to me because I started my LHSA career as the Project Archivist cataloguing them. With the help of a Project Steering Group and LHSA staff, I was tasked with developing a methodology to catalogue the cases as well as doing the actual cataloguing- so deciding what would be recorded in a catalogue entry, how the entry would be structured, and how long it would take to describe each case note. I remember how overwhelmed I felt looking at the cases for the first time in the University Collections Facility - shelves filled floor to ceiling with blue boxes! Not only did the sheer number of records seem scary at first, but the case notes were written in very specialised medical language, with clinical abbreviations and terminologies from more than half a century ago!

Do you understand what this means? I didn't when I started cataloguing....

However, after getting to grips with the cases, I developed a way of describing them that conveyed their key content in language that could not risk identifying patients, whilst using 'labels' to mark details for redaction that we wanted to record but couldn't be revealed to the general public (like patient names, for example). After this, cataloguing began in earnest...

Although I  became Archivist at LHSA in early 2014, I went on to supervise the day-to-day work of the project, so I've been lucky enough to be 'working with' Norman Dott for nearly five years now! My job lately has involved redacting the 28,000+ catalogue entries so colleagues in the CRC Archives and Learning and Development teams can work on developing a web presence for the catalogue.

So I'll be sad to say goodbye to Norman Dott, who's been a bit of an obsession for five years (I try to diagnose neurological conditions on TV medical documentaries, it's gone that far..), but over-the-moon to see the catalogue online for the first time! 

You can try the catalogue for yourself here. We're also cataloguing case notes from other specialisms (including our tuberculosis and diseases of the chest case notes), which will appear on the site as catalogues are completed and redacted.

'Even finding an envelope takes so long...'

This week's blog is from Kim, our Employ.ed intern, who gives us an insight into letters from our Ernst Levin collection that make difficult reading:

It’s Kim again, the Employ.ed on Campus intern working with LHSA on Ernst Levin’s personal archive. Last week marked the mid-way point for my internship here in the CRC, which has made me feel somewhat nostalgic, it feels like I started yesterday! In the last five weeks, I have made incredible finds in the uncatalogued mountains of correspondence, particularly in relation to the themes of German-Jewish immigration and refugee history. Over the first few weeks, once I had got to grips with the general outline of Ernst’s story, I identified areas of interest in the collection worth closer inspection. Often this was a series of letters or correspondence of particular value, such as the letters sent between Ernst and his daughter whilst he was interned as an ‘alien’ on the Isle of Man in 1940. I have now almost completed the process of drafting these various ‘narratives of interest’ into blog posts which will constitute my final outreach resource. Hopefully, this will generate some interest in the collection to secure the funding it so greatly deserves. Keep following LHSA's blog and social media for the address of the final resource!

Wartime letter to Ernst, who was interned on the Isle of Man in 1940 (GD8/2)

This week has been very busy with exciting events: the University of Edinburgh hosted the British Association of Jewish Studies ‘Jews on the Move’ conference from Monday to Wednesday, with expert speakers on the subject of Jewish history, immigration and refugees, which supplemented my research into Jewish History as a context for this collection.

The following is an example extract of the kind of content which will feature on the resource I'm compiling about Ernst. Below is a series of letters written to Anicuta Levin, Ernst’s wife, by an old friend called Grete Vester, who was struggling to survive in war-torn Munich in the immediate aftermath of WWII from 1946-47.

Anicuta Levin, c. 1930s (PG8)

 At the end of the Second World War, with the Nazi’s defeat, the three major allied powers entered Germany from different fronts. German civilians, especially women, faced the wrath of victorious allied forces: horrifying stories of rapes across Berlin abound. The Russians liberated Berlin from the East, whilst the British moved through France. Munich, the Levins’ home prior to emigration, was a US occupied zone, as evidenced by the censorship stamps on the letters Anicuta received from an old friend Grete Vester. 

Censor's stamp on a letter from Grete, 1946 (GD8/2)

Germany entered a period of extreme economic devastation and hardship, and the people suffered under the extreme war reparations claimed in compensation for the horror of the Holocaust. Trials were held across the country to punish ex-Nazi officials and purge Nazism from society: this process, as Grete writes, was called ‘Entnazifierung’ [de-nazification].

A series of letters from Grete Vester in Munich, with envelopes marked ‘American Zone’, and stamped with ‘U.S. Civil Censorship’ were sent to Anicuta Levin in Edinburgh between summer 1946 and 1947. These embittered letters from the Levins’ old friend show the extent of damage to war-torn Munich and the suffering of Germans in the extreme economic hardship of 1946 and 1947. Grete Vester, identified as one of the ‘old group’ of Munich friends in which Anicuta and Ernst socialised, is described by her sister Marla as having had three strokes throughout the course of the war.

This series of letters touches on the major theme of German post-war identity – Grete expresses extreme anxieties around being deemed a Nazi by ex-neighbours and friends who had fled Germany due to persecution. She ardently claims that she was not a collaborator and in an angst-ridden tone bemoans the fate of German ‘innocents’. She describes post-war Germany as a ‘living hell’: the embittered people are murdering each other like savages. On several occasions, Grete expresses suicidal thoughts, reflecting the unbearably desolate circumstances in the ruins of central Europe.

                                           

Typewritten letters from Grete (GD8/2)

4th April 1946:

“After six years of never-ending bad luck and abandonment, I am now writing to you full of hope and joy … in 1939 I had the bad luck to have a stroke and have been paralysed in my left side since then, although I can move again now, though with difficulty. In this state I spent the war, although I was evacuated to [Bad] Aibling. Now I am back in war-torn Munich, which you would barely recognise. Through the wretchedness, everywhere you look the people have become mean and embittered. The only thing I now long for is death. Kluger of course left me a long time ago, married a woman and had a child with her, though they are divorced already now. Obviously he already has someone else, because men always fare better in this matter”

“Oh, Anicuta, what did we live through! … I actually barely know what I should write, it cannot be expressed in words! … I would love to come and stay with you, and help with the housework”

(undated) April 1946:

“For God’s sake stay where you are! Don’t even consider trying to alleviate your homesickness for Germany! … I, a nazi-hater, as you know, should actually have a say in their [the Nazis] punishment! But the so-called ‘entnazifizierung’ [‘de-nazification’] is in someone else’s hands completely. Even us, the blameless, are suffering! I truly marvel at the fact that I didn’t end up in a concentration camp because of my big mouth [anti-Nazi discourse]. I guess that’s luck, or bad luck, however you might see it now”

16th August 1946:

“The letters which I so undeservedly receive from abroad are like balsam on my wounds … I was evacuated to Bad Aibling after a heavy attack on Munich … in the bomb shelter, everybody was drinking and flirting … they wanted to live their last hours with courage, or at least in the spirit of gallows humour … the basement doors flew open and the sounds of the bombs exploded in my ears and I waited for the end to come at any moment. But it passed, as you can see … When the Americans came, we were glad”

19th August 1946:

“I am constantly completely alone, at best Marla stops by with a cold face and the oft-used words “I don’t have much time, will need to leave in a few minutes””

Writes that her sister Marla tends to her out of a sense of duty, but there is no compassion or kindness behind it. Sadly she is reliant on her sister for vital supplies. Grete pleads with Anicuta not to mention her complaints in her reply as Marla reads through her letters.

5th October 1946:

“I am living with complete strangers, not good or bad, just very uninteresting and also uninterested in me, we were just stuffed in here by the housing department, regardless of what you want. Otherwise you have to sleep in the street. The room is tiny, 2.5 – 4.5 metres, so I can’t put my few possessions anywhere … You cannot imagine what the city looks like now … I only get visitors when I have cigarettes and coffee from my American parcels”

[speaking of an old friend she has corresponded with] “Sadly I get the feeling that she holds us all in contempt, even me, who was anything but a Nazi. This hurts me as I cannot be to blame for being German, and cannot change this”

“The Unolds are somewhere in the countryside. Did you know Grete’s sister, Mrs Keis? She died and recently her son was murdered and robbed on a train. These things happen often these days. This is what desperation does. It doesn’t make people better. No one dares to walk the streets after dark, especially not women”

11th October 1946:

“I have been wanting to write to you about how I live, because I think this isn’t uninteresting to you. I think that all of you who left Germany, have no idea how it is here. Firstly, there is the devastation of the ‘luftkrieg’ [air raids], which is indescribable, although some people say that Munich is gold in comparison to some cities like Frankfurt [hit more intensely] … I need cod-liver oil and vitamin C. Of course you cannot get these in Germany, so I’ve written to New York and Switzerland and have received some already. We’ve had this appalling food for years and Hitler had been giving us low-quality food since 1933.”

“The atmosphere among the people is indescribable. It is as though one were among savages, no it is worse, since savages probably have naïve qualities that make them worthy of being alive … even the so-called ‘qualified’ people leave a lot to be desired. The whole of Germany has been completely ruined by the Nazireich”

[Grete asks Anicuta repeatedly not to be angry at her for requesting so many times that she join them in Scotland.]

2nd November 1946:

“As you can see, I am already writing on your new paper. Yesterday your package arrived. I thank you warmly and am so happy that at least this worry is alleviated. Sadly the package had been broken into and the typewriter ribbon was stolen out of it. But we are used to these things now … the ribbon clearly showed through the wrapping and someone decided to steal it. Here, people take everything. The people are so poor, that even an old cloth isn’t safe, if it can still be used to clean things with. Hitler left us a great country and through desperation, the people have not improved, but the opposite. This is the reason I can hardly bear it here anymore. Do you understand? … Even finding an envelope takes so long, because you have to go into many shops before you finally have the luck to find one or two”

17th November 1946:

“Today I have a big favour to ask you. In Edinburgh there is surely a phonebook for London, where you can find an address which I don’t have here. It’s the address of Dr Philip Hochschild, who emigrated there. He is a very wealthy man, and could I please ask you to write to him explaining my situation and asking him to help me a bit. I was often with him in the time of the Hitlerreich and so he knows, that I wasn’t a Nazi, which means he might be prepared to help me, considering my illness. From abroad, you can send a care-package through the Red Cross … [pleads Anicuta not to think worse of her because of this request] … we are starving and freezing. We don’t have access to the most basic amenities. Often we don’t have any light because the electricity goes. Then we also can’t cook anything, because we don’t have enough gas or fuel. We don’t even have any candles and not enough matches!”

26th December 1946:

“I received your long-awaited letter yesterday. It was truly the most wonderful Christmas gift. Hopefully it won’t just be a seasonal occurrence … letters are my only joy, and I receive them so rarely. So please don’t be so sparing! Remember than I am alone and lonely. Maybe then it will be easier for you to write more often”

“I am interested to see what we still have to live through, before life is over for us. Sometimes I think, I must have been a real piece of work in a past life, to have deserved such a punishment … no one laughs here anymore, at best cynically, which isn’t so nice”

“There are still Jew-haters here, Hitler really created long-lasting effects. It is awful. Us Germans are really suffering from this, even if one wasn’t a Nazi. And I think that won’t ever change, at least in my lifetime”

13th January 1947:

“My dear Anicuta, I thank you warmly for your last letter from the 18th December. I think I have already answered it, but am not completely sure, as I think of you almost all day long and therefore no longer know, whether I wrote to you or just meant to and thought of you intensely. I am alone for days on end. Marla often doesn’t come for a week, because as she says she has no time. And I sit here in my lonely room with hardly any wood to burn and a great sense of fear … Life is nightmarishly hard. I never dreamed that things would turn out this way. Maybe you can tell, that I don’t want to be alive anymore. But I am scared of death too. Do you understand this? There are also other things which I can’t write about. It would be such a joy if I could see you again … don’t be angry that I’m starting with all this again, because I really do think this would be the only thing that could save me now”

27th February 1947:

“You can hardly imagine what wretched lives we must lead now, even us, who were never Nazis! … You know, of course, what I thought [of the Nazi regime] and how I often opened my mouth to speak against them, even though I was spared the concentration camps. Even in Bad Aibling, where my hatred of the Nazis was well known! It seems disgraceful to have to re-iterate this to you, who knows all of this so well! But when one reads and hears how so many Nazis are trying to wash themselves clean [of their crimes], one thinks, perhaps even friends like you might believe this of me”

15th September 1947:

“I hardly dare to ask, if I couldn’t come to you [in Scotland], you seem to stall which makes me very unsure. Please don’t be offended, but just say yes or no. It is awful in Germany. You can only get medicine in very extreme cases, and life is horrible”

Not at all sketchy! Volunteering with LHSA

In common with other colleagues in the Centre for Research Collections, LHSA hosts volunteer placements and paid internships throughout the year. As in many other professions, gaining practical experience is a vital gateway into careers in the heritage sector, and our placements aim to help those at various stages: from those who've never really been 'behind-the-scenes' in an archive before to aspiring new professionals seeking their first paid experience to build up a specialist CV. Vannis Jones is one of our volunteers, and comes in for one morning a week. In her final year of an Art History & French degree here at the University, Vannis approached us last year with a view to gaining the experience she needed for a place on a professional qualification in archives after graduation. In her blog, she talks about the material she's been working with recently, from a medical business (literally) very close to home for us here at LHSA:

Hi there, I’m Vannis and I have been volunteering with LHSA since January. Having recently received a conditional offer of a place in the University of Glasgow’s MSc programme in Information Management and Preservation (largely thanks to LHSA!), this placement has given me a wonderful opportunity to gain experience in the archives sector that I have no doubt will be immensely useful during my studies in Glasgow! I have now catalogued three small collections during my time here, the largest of which, pertaining to J. Gardner & Son, Surgical Instrument Manufacturers, I would love to share with you today.

The collection primarily consists of sketchbooks and loose sketches of surgical instruments and artificial limbs (and the occasional, and seemingly rather random, veterinary instruments...) produced by J. Gardner & Son from the late nineteenth century to the mid-twentieth century. J Gardner & Son opened just across the road from the University in Forrest Road, where the pub, Doctors, is now. The sketches often detail not only measurements and other forming specifications for the instruments, but also frequently the hospital, ward, and doctor who commissioned them. The majority of these commissions came from doctors and hospitals in Edinburgh and Glasgow, but some are from as far afield as Carlisle or even Stornoway, on the Isle of Lewis!

One of the biggest challenges in working with this collection was not actually the content - thankfully almost all instruments were labelled in the sketches, and any that weren’t I was generally able to identify using my trusty illustrated copy of J. Gardner & Son’s 1913 catalogue - but rather the condition of the materials. Large parts of the collection have clearly been saved from a fire at some point, as a number of pages are singed and crumbly at the edges, covered with a thin layer of ash. This fragility, combined with the fact most of the sketches have been folded for decades, means the sketches are heavily creased and the pages fall apart and rip easily - it’s going to be a bit of a challenge for the conservation team to get them ready for the reading room! A secondary issue is the dirty, dirty hands you walk away with after handling the collection. Old graphite and ash from a long-forgotten fire are not the best of combinations…

This sketch of trephine forceps from 1910 encapsulates almost all the conservation issues this collection has to offer—creases, detached bits of paper, singed edges (particularly at the top), and accumulated dirt on the page (GD47/1/7)

Having just completed my undergraduate degree in History of Art, I was also able to look at this collection through an art historical lens, and I grew to appreciate the strengths of the different artists employed to sketch at J. Gardner & Son. One of their most prolific designers was someone I have been able to identify as ‘T. Weir’, whose sketches often bordered on art. T.W. generally put a decent amount of effort into making his sketches not only extremely precise and detailed, but also aesthetically pleasing, and at times, beautiful. You would think that this accuracy and attention to detail would be common amongst all surgical instrument designers, but there was at least one J. Gardner & Son designer who was decidedly not particularly artistically inclined! (Incidentally, he never chose to sign his work.)

Dissector and probe image, caption: A beautifully clear and precise sketch of a dissector and probe by my new favourite 20^th century artist, T. Weir. 1910 (GD47/1/7).

Our only hope is that the final form of this detachable bronchoscope was not quite as wobbly our anonymous designer has depicted… (GD47/1/7)

As someone with absolutely no legitimate knowledge of surgical instruments or their usage, I did at times come across instruments with rather comical names—comical to a layperson, at least. The vast majority of the instruments were run-of-the-mill types like forceps, knives, scissors, probes, and the like. However, I would from time to time come across strange instruments such as a ‘special scalpel’ or a ‘pad for heating kidney’. Far and away my favourite oddity I have found in the collection, however, is the intestine crusher. Now, this was one of those instances where you read the name of the instrument, and assume you’re having some sort of palaeography issue. But no, the handwriting is quite clear—it’s an intestine crusher. This instrument in particular sticks out in my mind because while a number of the instruments in the collection sound unpleasant (‘brain knives’ come to mind), it is at least possible to imagine that they could serve some sort of beneficial medical purpose. Nothing about ‘intestine crusher’ says ‘tool of healing.’ A quick Google search returns results related primarily to meatpacking, an unlikely use of the J. Gardner & Son instrument, so perhaps we may never know its purpose. After all, I am no doctor…

 The infamous intestine crusher (and one of the few sketches in ink!) - GD47/1/7

Overall this has been a really fascinating collection to work with, and has presented a wide variety of challenges that I am sure have prepared me well for many more archive-based projects in my future. It has been really interesting to broaden my personal horizons by working with materials that deal with matters outside of my area of expertise, but that were also somehow familiar in that a number of the sketches were in some ways like pieces of art. I certainly look forward to many more exciting projects at LHSA, and more opportunities to facilitate the public’s access to our rich and diverse collections!

I'm sure you'll be pleased to know that Vannis finished her History of Art & French degree with First Class Honours and graduated this week! You can find out more about volunteer and internship projects in the Centre for Research Collections here.

Let’s talk about…SEX

This week, Project Cataloguing Archivist Clair talks about what she's been finding in her case note collection...

As has been mentioned in previous blogs I am working as part of the wider University Collections Facility rationalisation project to continue cataloguing work on some of LHSA’s case note collections. In particular, these are sexual dysfunction case notes from the Gynaecological Out-Patient Department at the Royal Infirmary of Edinburgh (RIE) which date from 1973 – 1994. We have around 1249 individual patient case notes from this period, and I have had the opportunity to learn from this primary source about the types of medical conditions and treatments that these patients experienced. This is an important collection because it is a very different medical specialism in comparison to other case note collections that have already been catalogued at LHSA. The case notes come from a more modern period and are structured slightly differently, which is reflected in their content. The circumstances relating to sexual dysfunction were often a combination of physical and psychological conditions and required a different medical approach.

The history of sex and sexuality is an area in which I have done a little studying before, but reading through the case notes has given me another perspective of both sexuality within a medical context and the relationship between sexual activity and physical and psychological health. Gaining insight into any topic relating to sex is interesting because of its importance to the human existence, being such a natural part of the human condition, yet historically the freedom to discuss sex and sexuality has been inhibited by values and beliefs through the ages. Although the sexual dysfunction case note collection covers a relatively late period, they give us a snapshot about how discussions surrounding sex and sexual identities are constantly evolving. In reading the case notes, I have reflected on my visit to the ‘Institute of Sexology’ exhibition at the Wellcome Library in 2015, which revealed a vast and varied selection of archival material, art, film and artefacts tracing the evolution of the way in which sex is studied. The exhibition showcased the work of many key sexologists including Sigmund Freud, Marie Stopes and Alfred Kinsey and showed how they lifted sexual taboos, developed a legitimate area of study and created a place for sexual health within mainstream clinical practice. Although the exhibition is finished, here is a short film of what was a fascinating tour.

Throughout the period reflected in the case notes (1973-1994), there are a broad range of issues addressed at the sexual dysfunction clinic. Many common medical conditions (for example, dyspareunia - pain during intercourse - or erectile dysfunction) were documented, and could often be treated successfully with a course of sexual therapy, drug treatment or, frequently for women, a minor gynaecological surgical procedure. However, the case notes also demonstrate that many sexual problems faced by patients manifested within the context of sexual relationships. Common sexual issues could be directly related to stressful relationships, living conditions and occupations, as well as ignorance or fear of sexual feelings. Some of the content of the case notes was upsetting to read because some of the patients had gone through traumatic experiences. Moreover, social attitudes towards sexuality or lack of sex education was sadly a common factor for many patients that came for help, who feared that they were sexually 'deviant', or risked being stigmatised because of their ‘unconventional’ sexual feelings.

Sexual problems categorised as a ‘dysfunction’, including frigidity, sexual unresponsiveness, loss of libido and orgasm disorders, were regarded as symptoms of emotional, psychological and personality disorder and thus were often treated thorough a course of sexual/marital/couples or individual therapy. Each patient visiting the clinic presented their own set of very personal and specific problems, so it is difficult to generalise or pick out cases that are representative of many. However, below are redacted extracts from two of the case notes that provide an indication of the complexity and array of deep-rooted issues experienced by patients.

PR1.552 (1)

PR1.552(2) These extracts come from the same file and show how attitudes towards sex and sexual feelings can be established from an early age and the way it was often seen as a taboo subject. Negative connotations of sexual activity as wrong or dirty appear as problems for many patients amongst the case notes. Bad feelings about sex often inhibited patients to form loving, healthy sexual relationships.   



PR1.555 This extract reveals the difficulties that some patients faced surrounding sexuality and gender identity.

 Patients were often referred by their GP or could make a direct appointment to be seen by one of the specialist at the sexual dysfunction clinic, based within the Gynaecological Out-Patient Department at the RIE. Key figures in the Department were Dr John Bancroft, Psychiatrist, and Philip Myerscough, Consultant Gynaecologist. Although I have struggled to find out more about Myerscough and his career, it appears that after Bancroft’s time in Edinburgh he became Director of The Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University. His research and work can be found spans many titles, including Human Sexuality and its Problems (1983). From a quick skim of this book, one can see reflections of his working practice and ideology seen in the case notes. Although it is often recorded that patients were too embarrassed to attend their appointment at the clinic or came in secrecy for fear of others finding out, the progressive nature of physicians such as Bancroft and Myerscough made many patients feel at ease. In his book Bancroft describes the feelings that many patients have which contribute to their sexual problems, including anxiety, anger, insecurity, guilt and low self-esteem. This level of understanding of all factors that affecting patients and his impartial approaches are revealed in the case notes, particularly when treatment programs or courses were tailored to meet specific patient needs.

Cataloguing these case notes using a similar methodology to other LHSA case note cataloguing projects has been really interesting because of the trends that can be spotted over time and the impressions that can be gained about a particular topic. Dr Gayle Davis, Senior Lecturer in the History of Medicine at the University of Edinburgh, used the sexual dysfunction case notes before they were catalogued for her research into the medical response to infertility in late 20th century Scotland. Therefore, we already know that there is an interest in using this primary source material and we can aid research by creating catalogues as a better way in to the collection. We hope that the way in which the case notes are described in the catalogue will help to highlight other potential areas of interest to the research community. The case notes can be explored without revealing anything biographical or medical which could identify those who were treated - this is not only important because of the information legislation surrounding health records, but also due to their sensitive subject matter.

This catalogue will go further in making our growing collections on sexual health, gender and sexuality accessible - collections that cover women's health and activism, reproductive health, LGBTQ+ health, HIV and AIDS awareness and the treatment of venereal disease.

Objects of mystery

Archivists like lists. We like box lists, catalogues, inventories. We like knowing what we have and where it is. This isn’t always straightforward, though, and sometimes things turn up that stump us all. For example, my first ever cataloguing assignment involved working with the papers of a prominent Scottish art critic. Two days in I came across an instruction manual for a radio. Was this an integral part of this critic’s routine? Did she listen to the radio whilst writing? Did she read the manual before she sat down to an assignment? Were there some particularly striking illustrations that she enjoyed looking at to put her in the right frame of mind? Or was it that the manual had just fallen in to the box before she’d loaded up the car and driven to the archive?

Deciding what to keep from a donation or accession is a process called ‘appraisal’, which involves assessing the value of materials according to pre-agreed criteria – although what ‘value’ means is a very contentious and much debated issue! Sometimes, we have to take things in without being in a position to make informed decisions about their value. As we’re seeing more digital media come into the archive in obsolete or hard-to-access formats like floppy-disc or Betamax tape, we can’t always be sure what is on them, so sometimes we agree to take them in on the assumption they will be of value. Other times, it’s not accessing the information that’s the problem – sometimes we simply don’t know what an item is!

The LHSA objects database is a good example of this. Broadly speaking, archives tend not to collect objects - this is more the purview of museums - but LHSA does hold over 1000 objects, ranging from badges and condoms to straitjackets and clocks. The collection includes around 300 medical instruments and implements, such as these wonderful drug cabinets:

M026 & M027 - Drug cabinets

With so many objects, it’s not too uncommon to come across entries in the database with the description ‘function unknown’. Now, my archivist’s brain finds this difficult to deal with and internally I’m screaming “everything must be correctly labelled and identified!”, but although we’ve come to know a lot about the history of medicine through working at LHSA, none of our staff are medically trained, and nor are we medical historians.

M250 - previously listed as an 'unknown device' from Leith Hospital 

Earlier this week, Twitter came to my rescue when Robert Culshaw (@RobertCulshaw) helpfully clarified that these mysterious and alien-looking metal items were in fact the two parts to an amputation shield, explaining “they go around the bone to retract the muscle out of the way ready to saw through it”.

Eep.

With that in mind, we’re calling on the expertise of our followers – can you help us identify some other instruments? We’ll be sharing photos of a few 'unknown' objects on Twitter over the weekend. Get in touch if you can help solve any of these mysteries! Here are two to get you started....

M202

M214

In which intern Emily says goodbye…

Well, the last 8 weeks have flown in and here I am writing my second and final blog post. 

Photograph of resected aneurysm

I have continued to catalogue and conserve Andrew Logan’s case notes. There are 477 in total, and the majority consist of a case summary and a duplicate copy, some included reports (such as pathology and post-mortem reports) and correspondence, sometimes from other doctors and others from grateful family members. One case note also contained photographs of a re-sected aneurysm, interesting and stomach-churning in equal measure. This provided an opportunity to learn another conservation skill. To protect the photograph and the corresponding case note, I was taught how to make a protective wallet using acid free paper.

After conducting a little more research I can now provide a bit more background to Andrew Logan, as promised. In 1948, Logan was appointed to establish the unit for cardiac and thoracic surgery at the Royal Infirmary of Edinburgh. It was around this time that rheumatic fever was prevalent, resulting in progressive damage to heart valves, particularly mitral valves. Many young and middle aged patients died from unrelieved congestion of the lungs. In response to this, Logan pioneered the use of a trans-ventricular mitral valve dilator for mitral stenosis. This method proved very successful and this is reflected in the case notes. The majority of the case notes related to mitral valve stenosis patients and the vast majority seem to have survived the procedure.

Dr Andrew Logan (c.1965) PLI/D/068

As an interesting side note, although he smiles sweetly in his portrait, the manner in which he ran his surgical was supposedly rather different. Apparently he preferred an autocratic and dictatorial style of managing. There are a couple of anecdotes to support this, however, my favourite has to be:

During surgery, when a registrar apologised for inadvertently removing a clamp from the aorta during a coarctation repair, Logan replied, ‘I should be the one apologising, I am the one who employed you’.
Perhaps his portrait smile is reserved for his bed-side manner.

As time passed, case notes became easier to navigate, in the sense that I was able to predict where I would find specific details of conditions or treatments for the catalogue. For the purposes of this project I was encouraged to use the Medical Subject Headings Browser (MeSH) produced by the U.S. National Library of Medicine to locate appropriate index terms for the catalogue. As well as this the Centre for Research Collections (CRC) have developed a collections management system that links an index term with an authority number. As LHSA have already catalogued a significant amount of clinical case notes, a great many index terms had already been established. I was taught how to search for and add new index terms to the collections management system if needed.

The conservation guidelines provided during training were very useful in getting started as I found the idea of rehousing a little daunting in the beginning. A major fear being that while trying to remove a paper clip I would inadvertently rip something in half. (Luckily no such crisis occurred.) I began the process quite slowly, as advised, following the guidelines and removing paperclips and flattening creases as carefully as I could. As my confidence grew, I made small changes to the process that would ultimately quicken the outcome. 

One of the aims of this project was to try and develop a method to enable future projects to catalogue and conserve at the same time. Because of the way it worked out with scheduling, by the time I got round to conservation training in my second week I had a considerable head start with cataloguing. I was about 100 case notes ahead by that time. I thought that rather than trying to catch up with myself, I would try and consistently split my time between conserving and cataloguing, so I was never more than 100 case notes ahead in cataloguing.

Before conservation and rehousing.

One reason I found this easier was that cataloguing before conserving allowed me to familiarise myself with the case notes and take note of any features that may pose a challenge.

After conservation and rehousing.

On reflection I would say that the project was successful. I was able to catalogue and conserve the case notes well within the allotted time. As you can see, in the ‘before’ image, case notes took up an entire shelf and their original state on the shelf was not ideal for long term preservation. In their rehoused state they are safe and secure, and they take up far less shelf space. This is a positive result for the University Collections Facility Rationalisation Project, whose aim is to make sure that collections held outside the main library are stored appropriately and accessible for the future. Also, learning conservation skills was very worthwhile as it now forces me to consider the needs of the physical document rather than focusing purely on the content.

I have not been glued to my desk for the entire internship. Other things I have been lucky enough to do over the last eight weeks include a tour of the anatomy school, a print making class, a visit to the National Records of Scotland, a tour of St Cecilia’s and much more. In my last week I have also been helping Clair catalogue Sexual Dysfunction case notes. This has allowed me to familiarise myself with a different kind of case note, and of course, another load of terminology to wrap my head around.

Working with LHSA has been everything I wanted it to be and more. I have learned invaluable skills working with an extremely interesting collection, and I have met many lovely people from variety of working backgrounds, all of whom have been extremely generous with their time. Conserving as well as cataloguing has significantly altered my perspective. When I look at records now, I will not only focus on their informational value, I shall also consider what measures I can take to ensure their physical preservation, and use my skills where possible to achieve that.

I think all that remains is to say thank you very much to LHSA for having me, it has been a pleasure and a privilege.

Found in translation...

This week's blog comes from LHSA's new intern, Kimyana Scherer. Kimyana's with us as part of the Employ.ed On Campus scheme, which offers paid internships to students throughout the University during their summer break. Kimyana's working on an exciting collection of personal papers - which have already become a lot more accessible through her German-language expertise! As you'll read below, she's made some fascinating discoveries:

Hello, readers of the LHSA blog!

My name is Kimyana and I am the new intern working at LHSA through the University of Edinburgh’s Employ.Ed on Campus scheme. I study English Literature and History at the University of Edinburgh and am going into my final year after the summer. I was drawn to this internship and working with the LHSA as I had taken a module in Modern Jewish History which ignited my interest in Jewish history, which I plan to make the topic of my dissertation. My bilingual upbringing by German parents is already proving an advantage in reading the old German documentation and script in the collection I'm working with. I've had little formal experience with archives, and think that many students are unaware that this fascinating discipline is a potential career path! The Centre for Research Collections and all its staff have been exceptionally welcoming in giving talks and tours of their departments and stores, including Rare Books and Art Collections – I find the interdisciplinary, varied nature of these jobs incredible!  

Sample of correspondence in Kimyana's internship collection (Acc15/001)

My work is on the collection of Dr. Ernst Levin (Acc15/001), a Jewish-German neurologist who emigrated from Munich to Edinburgh with his wife Anicuta and their daughter Annakathrin before the Second World War. LHSA received a donation of twenty large boxes of personal archive material including very old photographs (some of which predate the turn of the twentieth century), hundreds of letters, some medical case notes and personal items. My task is to gain an insight into the lives of Ernst and Anicuta through the closer study of their correspondence with family and friends across Europe in the years of the Weimar Republic and beyond. 

An early picture of Ernst from his transport pass, when living in Berlin (Acc15/001)

The young Anicuta

Anicuta, who spent her early life in Bucharest as daughter of the wealthy Belau family, ran in bohemian and artistic circles and had an interest in fashion and drawing, as evidenced by photographs of the group in costume dress and sketchbooks. 

Studio photograph of Anicuta, c. 1910s (Acc15/001)

Anicuta's sketch book showing her interest in costume and fashion (c. 1930s)

Through the eventual creation of an outreach resource, I hope to share this glimpse into a colourful and fascinating past with the public and demonstrate the value of personal archives and the documentation of personal histories. Archives are often necessarily filled with the documents and artefacts of the elite, a symptom of ‘great men’ history, yet the tracing of an ‘ordinary’ life across war-torn Europe provides an invaluable window into the context of history.

Sketches found in the collection so far (Acc15/001)

There have been challenges in working with such a large, mixed collection: not least of which is the difficulty in reading the heavily italicised script of individuals writing in the early 1900s. There are, however, ways to overcome these obstacles, such as by trying to date correspondence between individuals using stamps and addresses. Photographs, too, can be put in context by analysing the photographic paper on which it is printed or notes on the reverse.

Another interesting find.. Anicuta's school report, 1900s (Acc15/001)

Of particular interest were the passports of Ernst and his wife Anicuta, who travelled between Britain and Germany several times. Visas and stamps for landing permission in England are renewed several times over the course of 1936 and 1937. The rise in the Nazi regime’s prominence can be seen in the difference between the ‘nationality’ qualification in the 1929 passport and the 1939 one. In 1929, Ernst is qualified as a ‘Bavarian’ citizen; by 1939, he is a citizen of the ‘Deutsches Reich’, with a list of responsibilities of German nationals abroad glued to the inside cover of the passport.

We'll hear more from Kimyana as her internship goes on and she makes more fascinating finds...