Friday, 26 May 2017

Introducing our new intern...Emily!

My name is Emily and I am the current cataloguing intern with LHSA, welcome to my first blog post. I thought I would take this opportunity to tell you a little about myself and the collection I have been working on.
I am nearing the end of my MSc in Information Management at the University of Glasgow. Alongside the internship I am also working on my dissertation, which is due at the end of August. I will be studying the implications of digitizing psychiatric hospital records, specifically those of the former Hartwood Hospital. The records for this institution have recently been acquired by the North Lanarkshire Archives, where I volunteer. Very handy indeed!

Before entering the working world as a new professional I felt it was important to obtain as much work experience as possible. The LHSA internship was a perfect opportunity for me to expand my skill set, and to work with an archive service I had long been curious about.

One of the most exciting things about archives is the vast variety of collections there are to discover. I have never encountered a collection I did not enjoy working on. I do however, have rather a spot for healthcare records, presumably because that is where my love of archives stems from. For my undergraduate dissertation, I studied the use of moral therapy at the Crichton Royal Hospital. The Dumfries and Galloway Archives was the first repository I ever set foot in, and I was astounded by everything I was shown. I loved perusing through the registers, copies of the New Moon (newspapers produced by the patients) and the beautiful scrapbook produced by Physician Superintendent W.A.F Browne. From this point onwards, I knew I wanted to work in archives, so back to school I went.
Dr Andrew Logan (c.1965) P/PLI/D/068
For the past four weeks I have been cataloguing and conserving cardiac thoracic case notes of patients treated by surgeon, Andrew Logan (1906-2005). The collection consist of roughly 470 case notes, dating from 1951-1958. Dr Logan (smiling beautifully in his portrait) was a consultant cardiothoracic surgeon in Edinburgh. It seems he was based at the Eastern General Hospital Thoracic Unit, while also heading surgical wards 7 (male) and 8 (female) at the Royal Infirmary of Edinburgh. Patients were referred by Dr Rae Gilchrist of the RIE Cardiology Department (wards 22 and 23) to wards 7 and 8 for thoracic-cardiac surgery. Over the remaining few weeks of my internship I shall research Dr Logan further and see what I can dig up.
Example of original patient case file.
While cataloguing this collection I have really enjoyed familiarising myself with some rather tongue-twisting terminology. I think my favourites have to be ‘patent ductus arteriosus’, ‘polycythaemia’ and ‘dyspnoea’. Thank goodness the case notes are all typed!

Removed rusty paperclips
Unlike other past interns, I have been given the task of conserving and rehousing, as well as cataloguing this collection. This has involved the removal of great many rusty paperclips and straightening the edges of some very flimsy paper (all good fun). The aim of this is to try and establish an efficient method for future interns to catalogue and conserve in tandem. So far so good, but I will share my conclusions on my next blog post.

Friday, 19 May 2017

How Pleasant Surroundings and Conditions affect the Health and Happiness

How do our surrounding affect our mental health? Access Officer Alice recently attended a conference organised by the Churches Conservation Trust and [Mind UK] to celebrate the opening of Quay Place, a new community mental health resource in Ipswich. Throughout the conference, there was a lot of focus on the impact our environment can have on us, and on the development of hospital architecture. Here at LHSA, we’ve been working with a number of artists and researchers involved in the redevelopment of hospital spaces across the Lothian area, and this has got us thinking about hospital architecture in a bit more depth. This week, Alice looks at Dr Thomas Clouston’s views on asylum design, and how the physical space of the Royal Edinburgh Hospital in Morningside was tied to its therapeutic outlook.

Dr TS Clouston was Physician Superintendent of the Royal Edinburgh hospital (REH) between 1873 and 1908, and during this time he also published extensively on the causes and treatments of mental illness. One of Clouston’s preoccupations seems to have been asylum design – indeed, whilst Physician Superintendent he undertook an expansive rebuilding programme, with a key part of his legacy being the opening of Craig House, a series of buildings specifically tailored for the treatment of private, paying patients of the Royal Edinburgh Hospital. As part of our Royal Edinburgh Hospital collection (LHB7), we hold two of his papers that give an insight into his thinking on asylum design: these are “An Asylum or Hospital - Home for Two Hundred Patients” (Boston, 1879), and “How Pleasant Surroundings and Conditions affect the Health and Happiness” (Edinburgh, [1887]).

As the title suggests, “An Asylum or Hospital…” was very much concerned with how to make the buildings under his charge comfortable for its inhabitants, and foster the community ideal that he felt was crucial to the successful recovery of patients. In it, Clouston begins by pointing out how attitudes to ‘insanity’ had changed over the years:

“In planning the asylums for the insane, built 70 years ago, the dominant idea in the minds of their architects was secure custody : in the case of those built 30 years ago, the idea of curing the patients had modified in a marked degree the jail-like features of the earlier buildings. Since that time, under the new regime in this country, improvements in the character of the hospitals for the insane have been going on steadily”.

The concept of custody was indeed a key shift in the attitudes of the time. Although ‘open-door’ policies didn’t find real traction until the mid-twentieth century, Clouston saw it as important that patients didn’t feel like inmates, and effort was made to obscure any necessary security features: “all the special arrangements of rooms, window-shutting, strong-rooms, padded rooms, &c., should be as little prominent and offensive as possible ; and above all, they should not be suggestive of what they are intended to prevent”. Not only could these security features be obscured, Clouston suggested, they could also become decorative features in themselves that added to the general positive feeling of the institution. For example, he details how to installed padded leather walls in  a secure room: “the surface of the leather should be neatly stencilled, and coated with four coats of the best varnish. It is then soft, impervious to urine, strong, and makes a pleasant-looking room, just like an old library hung with stamped leather. In this way the forbidding features of an ordinary “padded room” on the patient’s mind are avoided”.

LHB7/14/5 - A block plan for 'An Asylum or Hospital Home for 200 Insane Patients'
Indeed, Clouston seems to have wanted his patients to think of themselves more as residents in a grand hotel than patients in an institution: “in the general arrangements, furnishings, &c., I took a first-class hotel as my model, and not any pre-existing asylum at all”. In defending this relaxed and accommodating attitude, Clouston argued that, even if there were accidents or escapes, and if some physicians had relaxed their attitudes too far, “their indiscretion has done good. It has had for its object the restoration to ordinary conditions of life a portion of humanity that lay in fetters and chains 100 years ago”. By avoiding the tropes of the ‘insane beast’, Clouston thought, the patients of the asylum would develop a greater sense of self-respect, take more interest in their own personal care and appearance.

In this respect, the social aspect of the hospital was an important factor. By bringing patients together to dine “in rooms … the general arrangements of which are precisely those of a table d’hote in a good Swiss hotel in the summer”, Clouston relied on the enduring social nature of people to help improve patients’ opinion of themselves and capacity for social intercourse. He stated that “since we began to use a common dining-room … several inveterately untidy patients have been cured of their slovenliness of dress [and] self-control is taught. The public opinion of the room or the table won’t tolerate noise or disturbance”. The greatest complaint of patients, he stated, tended to be around their lack of control, lack of entertainment and often, their horror at being locked up with ‘lunatics’, and he therefore tried to remedy this by providing opportunities for what he considered “pleasant conditions of life”. These included, in his view, “suitable work for the doer of it with some leisure time, some agreeable companionship, games, amusements, newspapers, books, baths, and liberty of action”.

LHB7/14/5 - the ground plan for 'An Asylum or Hospital Home'
Another key element of Clouston’s design was to avoid “uniformity of accommodation and arrangements” throughout the hospital: in an awareness of different types of mental illness, and the illogicality of treating all patients in the same manner, Clouston stressed that all patients had different needs based on a number of factors such as their bodily health, their propensity to be dangerous to themselves or to others, and their potential ‘curability’. Accordingly, “it should be a principle, never departed from, that the structures and arrangements that are necessary for the worst classes of patients should not be used for the best…”.

In the same vein, Clouston believed that this lack of uniformity should extend to the d├ęcor: “variety in the shape, size, and aspect of buildings and rooms, tends to interest, rouse, and cheer the patients, when they pass from one into the other”. He acknowledged that architects and painters were often unwilling to expend their talents on an asylum, whether their efforts might not be as well received as they would be elsewhere in society, but stressed that variation and a lack of monotony in surroundings had a greatly beneficial impact on the mental health of patients.

Overall, Clouston was a strong believer that health and happiness were improved by pleasant surroundings. Furthermore, he saw the benefits of this for the professionals involved in the care of patients, asserting that “the management of an asylum is necessarily much affected by its construction … a cheerful, broken-up asylum is far more apt to be managed on principles that are pleasant to its patients”.

Friday, 12 May 2017

'A most peculiar bird...'

This week, Archivist Louise celebrates International Nurses Day with a spotlight on a resource that charts the history of nurse education from the first half of the twentieth century right up to the present day…

Happy International Nurses’ Day 2017! Since 1974, the International Council of Nurses has celebrated the amazing achievements of the nursing profession throughout the world. 12 May was chosen since it’s also the birthday of Florence Nightingale – whom I’m sure needs no introduction, but you can read more about our Florence Nightingale letters here. Around each International Nurses’ Day in the UK, there’s a service at Westminster Abbey in London, in which a symbolic lamp is passed, and more local celebrations in hospitals and health organisations. There are also annual events across the world (including these impressive displays in China).

We’ve no shortage of nurse-related records at LHSA – in fact, we have much more about nurses than we have for doctors! We’ve nursing ephemera, badges (like the ones featured on our new postcards – shameless plug!):

One of our new colour postcards!

… staff registers, photographs (although not always with named nurses), wage books and training records up to the early 1960s (when nurse training began to be re-organised from individual hospitals to wider local institutions – the Lothian Colleges). In fact, there’s a handy source list if you’re wanting to look into nursing records here.

One nursing history resource that I’d love to highlight, though, is The Pelican, the magazine of what is now The Pelican Nurses’ League, an organisation made up of nurses trained in the Royal Infirmary of Edinburgh. But why a Pelican?:

Royal Infirmary of Edinburgh nurses with an extraordinary patient! (LHSA photograph collection)
The Pelican had long been a symbol of the Royal Infirmary of Edinburgh, appearing on its crest. Shown as a female plucking its breast to nourish its young with its blood, it became synonymous with nurture and self-sacrifice, a fitting emblem for the work of the Infirmary as a charitable institution, and as a symbol of the RIE Nurse Training School (founded in 1872), appearing on its badge from 1917.
Pelican badge, Registered Nurse (LHSA object collection, O254)
Nursing badges were worn with pride, a very visual reminder of years of (often extremely challenging) training to meet rigorous professional standards. Back in 2011, we carried out the Unsung Heroes project with jewellery and silversmith students from Edinburgh College of Art to create new badges from our original archival holdings, taking inspiration from oral histories from retired nurses, recorded by the students themselves. You can hear some of the recordings online, here.

The first issue of The Pelican appeared in 1927, and was founded by the Student Nurses’ Association. The foreword of the first edition (written by the Lady Superintendent – the ‘Head’ -  of Nurses, Annie Warren Gill), welcomed the magazine, ‘which aims at reflecting and bringing together the many sides of a nurse’s life, and which will keep the old in touch with the new.’

Cover and first foreword from The Pelican,  1927-1928 (LHB1/190A/1)
Throughout its life, The Pelican has focused on nurse training rather than life as a qualified nurse. The PTS (Preliminary Training School) is often mentioned, where new recruits were educated before learning on the wards, along with ‘pros’ (not ‘professionals’, but ‘probationers’, who might be called student nurses now). The first magazine was a mixture of official news and events, along with anecdotes and humour:

Humour from the pages of the first edition of The Pelican, 1927-1928 (LHB1/109A/1)
'The Perfect Nurse' strikes a typical tone in early issues of The Pelican – of squinting up at an ideal, angelic nurse, but never quite reaching. It's a reminder that the (then) women who washed the bedpans, changed bandages and (as their training went on) administered treatments and aided operations were flesh and blood human beings doing their best against often unrealistic expectations that they carried with them as new starters.

A less well-known Pelican badge, that of the State Enrolled Nurse (LHSA object collection, O258). 
In 1935, the magazine recorded the suggestion of starting an ‘Edinburgh Royal Infirmary League of Nurses’, and that The Pelican be its official magazine, linking those who wore the Pelican badge. E F Bladon was elected the first President of The League at its first meeting in June 1935, and in 1936, The Pelican changed its cover to reflect its new allegiance:

Covers of The Pelican showing its name-change, and the first page of the new League edition (LHB1/109A/11, 12)
The Pelican changed its contents as the nature of nursing changed – in the 1940s, it appeared as a ‘News Sheet’ to reflect both wartime shortages and shifting priorities:

The Pelican in the Second World War, and news of nurses serving in wartime (LHB1/109A/16)
Teaching was changing too, as this 1957 feature on the new Teaching Unit shows:

Feature om the new teaching facilities for probationers (LHB1/109A/33)
In 1972, the Royal Infirmary of Edinburgh School of Nursing celebrated its centenary, marked with a special issue of The Pelican:

Special edition of The Pelican, 1972 (LHB1/109A/49)
I was heartened to see a feature by the Infirmary Archivist, answering queries about the Pelican crest in ‘most correct and proper’ terms (how else???!!):

Article by Pam Eaves-Walton, RIE Archivist (LHB1/109A/49)
 The Pelican continues to publish to this day, and the 2017 edition has just been sent to LHSA for the archive. As well as administrative matters (for example, member news, notices and meeting minutes), there are also historical features based on the editor's research in LHSA and recollections from nurses in particular specialist wards, such as Norman Dott’s Department of Surgical Neurology and the Renal Unit, where the first kidney transplant from a live donor in the UK was performed in 1960.

Appropriately for International Nurses' Day, modern editions of The Pelican also feature news on the Pelican Award, funds awarded to students on Adult Nursing Programmes in selected Lothian universities in support of electives (placements to supply experience of nursing outside their own region, but anywhere in the world) and to Registered Nurses towards funding research projects or professional development. In 2016, seventeen student electives were funded, from Birmingham to China, Sri Lanka, Australia, Tanzania and The Philippines – a truly international story for International Nurses Day 2017!

If you were the proud owner of a Pelican badge (according to the League records that we hold, Pelican badges were being issued up until at least summer 1988) and would like to join the Pelican League, new members are always welcome – you can find more details on the League’s website.

A probationer's life has always been a hard one...

Friday, 5 May 2017

Midwifery in Edinburgh

This is a big week for the history of obstetrics, gynaecology and midwifery in Edinburgh… May 1st saw the 120th anniversary of the opening of the Edinburgh Royal Maternity and Simpson Memorial Hospital; May 2nd marked 83 years since the death of Dr James Haig Ferguson, founder of the first hospital outpatient antenatal clinic in Britain As today is also the International Day of the Midwife, we’re taking the opportunity to look back at the history of this discipline in Edinburgh…
LHB3A/15/1 - Certificate awarded to Margaret Reid, Midwife by Thomas Young, 1768.
Midwifery in Edinburgh as a ‘medical’ (as opposed to community) practice dates back to 1726, when Joseph Gibson was appointed Professor of Midwifery by the Town Council. It wasn’t until the 1740s that Midwifery was taught to students of the University of Edinburgh by practising surgeon Thomas Young. Young believed that practical clinical instruction was crucial for a full understanding of midwifery, and in 1781 he tried to rally support for the building of a general Lying-in Hospital in the city that would allow his students this close-up experience. Young died in 1783 before his vision could be realised, and his successor Dr Alexander Hamilton took up the mantle after him.

GD1/1/1 - Midwifery lecture notes, n.d.

Hamilton outlined a General Lying-in Hospital as constituting “a proper building, erected in an airy healthy situation, capable of containing twenty-five patients”, but advised that it “should be constructed in such a manner, that it may be enlarged when the funds can afford it”. [5/6] His appeal was successful. The General Lying-In Hospital, opened in 1793 at the site of what is now Teviot Row House, aimed to provide “women in low life” with the “management during child-bearing that opulence can produce”.

Hamilton’s hopes for the Hospital to be extended were less successful, however, and it wasn’t until 1879 that a purpose-built maternity hospital was opened. Named after one of Edinburgh’s most famous medical sons, the Simpson Memorial Hospital honoured Sir James Young Simpson’s many contributions to midwifery. He had succeeded Hamilton in the Chair in 1840, and in 1847 his infamous private experiments into the anaesthetic effects of chloroform led to it being used to relieve pain during labour.

In 1905, John Halliday Croom was appointed to the Chair, but being a specialist in obstetric alone, additional expertise had to be sought and Alex Hugh Freeland Barbour was appointed as lecturer in Gynaecology. This dualism reflected a general attitude towards the care of pregnant women at the time - as R.W. Johnstone puts it “any special care deliberately devoted to the object of preserving the health of the expectant mother [or of] forestalling dangers likely to arise in her labour … was virtually unknown”.
Portrait of James Haig Ferguson, from the collection
of the Royal Medical Society
The concept of antenatal care was introduced into Edinburgh by Dr James Haig Ferguson. Haig Ferguson had served as Assistant Gynaecologist at the Royal Infirmary of Edinburgh since 1896, and in 1899 had founded a home for unmarried women expecting their first baby. Encouraged by the impact that routine antenatal supervision had on the health of the women treated there, he successfully petitioned the managers of the Edinburgh Royal Maternity Hospital to allow him to open an out-patient clinic for married women, so as to offer them the same levels of supervision. Due to the fact that most married women gave birth at home at the time, the Hospital had somewhat of a reputation: Johnstone recounts how “to protect these respectable women from embarrassment, entrance to the clinic was arranged from an unfrequented side street, and I well remember the great consideration that had to be given to their modesty in putting up an unobtrusive and discreetly worded direction-board.”
LHB3/7/71 - Annual report, 1915

And so, Britain’s first ante-natal clinic opened its doors in 1915. This coincided with the Midwives (Scotland) Act of 1915, which made training, examination and registration for midwives compulsory. Prior to this, many women working as midwives had become ‘certified’ - that is, obtained a certificate confirming their training in a hospital - but most were still without formal training.

The Midwives (Scotland) Act also saw the introduction of the Central Midwives Board in Scotland (CMBS), which recognised three categories of midwife at first: those who had taken and passed the CMBS examination; the ‘certified’ midwives who had previously obtained a certificate; and the ‘bona fides’, women who were enrolled “by virtue of bona fide practice”. This last category covered women of good character who had been in practice as uncertified midwives or howdies for at least a year. Although they could be enrolled without examination, one third of those taking the first CMBS exam were already on the roll as bona fides. As Dr Lindsay Reid explains in her book Midwifery in Scotland: A History, midwifery before 1915 was “alegal”, with no qualifications to meet, and no regulations or licensing requirements. The passing of the Midwives (Scotland) Act of 1915 gave new status to this group of women, some who had been formally trained, some of whom had been working with the benefit of knowledge passed down through generations.

The theme for this year’s International Day of the Midwife is ‘Midwives, Mothers And Families: Partners For Life’. By moving the focus away from the act of labour itself and onto the general health of the mother leading up to birth, Dr Haig Ferguson put in place the approach to maternity care that has led to this partnership; similarly, the decision by the CMBS to acknowledge the role that uncertified, locally-respected howdies occupied in the community ensured that those who might otherwise be reluctant to seek formal medical care were still being seen by an ‘approved’ practitioner. These partnership have now extended beyond the moment of birth, and in the words of the ICM, “midwives everywhere understand that by working in partnership with women and their families they can support them to make better decisions about what they need to have a safe and fulfilling birth”.

Friday, 28 April 2017

Lothian Gay and Lesbian Switchboard

This week our Skills for the Future trainee, Samar, will be sharing information and material from the Lothian Gay and Lesbian Switchboard archive with you…

At LHSA, we hold the archive for the Lothian Gay and Lesbian Switchboard, which includes material such as newspaper and magazine clippings, call logs, related research, promotional and fundraising material, correspondence and minutes. The Switchboard is worth celebrating, because it has protected and cared for LGBT+ people in our city for over forty years. When it was founded in 1974, the Switchboard’s primary function was to offer assistance and information to anyone who had experienced difficulties as a result of their own homosexuality or the homosexuality of a family member or other associate.

Lothian Gay and Lesbian Switchboard logos (left: 1970s, right: 1994) [Acc 09/021, Acc 09/027]

By 1984, the Switchboard had become the first LGBT+ charitable trust in Scotland, and moved into its own premises in central Edinburgh. Women’s charities soon provided funding for a separate women-only line to be added to switchboard as the Lesbian Line, altering the Switchboard’s name to the ‘Gay Switchboard and Lesbian Line’. The Gay Switchboard and Lesbian Line was, and continues to be, entirely staffed by volunteers, all of whom are LGBT+, because the charity feels that those who are a part of the LGBT community are in the best position to assist others with problems concerning sexuality. 

Literature found in the Lothian Gay and Lesbian Switchboard archive [Acc 09/021, Acc 09/027]

When the Switchboard was founded, phone calls would typically be on topics such as: HIV and AIDS, bereavement issues, sexual abuse, the laws governing homosexuality, sexually transmitted diseases, safe sex practices, coping with stress, how to come out of the closet, drug and alcohol abuse, reconciling their religion with their sexuality, dealing with harassment and abuse at work and at home, homelessness, relationship advice, how to make gay and lesbian friends, and parenting. Sometimes, other gay people just needed to talk with someone who knows what it’s like to be gay or lesbian and who will be able to offer non-judgmental advice and support. There were also calls from concerned friends and family who wanted to learn how best to support their LGBT+ family and friends. Some calls were handled on a one-off basis while others developed ongoing supportive relationships with volunteers from the charity. In 1992, Gay Switchboard and Lesbian line received 6,000 calls between each other.

Literature found in the Lothian Gay and Lesbian Switchboard archive [Acc 09/021, Acc 09/027]

In addition, the Switchboard offered other services and activities besides phone calls, such as a twice-monthly social group (also known as their face-to-face befriending service), fundraising parties, liaison with research groups (providing surveys and results for studies on homosexuality), speakers for talks on homosexuality and training for outside groups on a range of topics to do with homosexuality. The Switchboard also maintained a referral list of professional contacts, which included doctors, lawyers, psychiatrists, clergy and others who have a positive attitude towards homosexuality. The Switchboard also kept a list of ordinary people, such as LGBT+ people in long-term relationships and parents with LGBT+ children, who were willing to share their experiences with others.

Promotional material for a fundraising event held by Lothian Gay and Lesbian Switchboard [Acc 09/021, Acc 09/027]

It is significant to note that the work that Lothian Gay and Lesbian Switchboard did in the 70s, 80s and 90s is still relevant today. Stonewall Scotland, a charity that “supports individuals to work out how they can make a difference for LGBT people at work, home and in their communities”, conducted surveys in 2015 on the experiences of LGBT+ people today. They found that:
  • A quarter (24 per cent) of patient-facing staff working in health and social care have heard colleagues make negative remarks about lesbian, gay or bi people
  • A quarter (26 per cent) of lesbian, gay and bi health staff say they have personally experienced bullying or poor treatment from colleagues in the last five years as a result of their sexual orientation
  • Almost one in 10 (nine per cent) health and social care staff are aware of colleagues experiencing discrimination or poor treatment because they are trans
  • Nearly half (48 per cent) of trans people under 26 said they had attempted suicide, and 30 per cent said they had done so in the past year, while 59 per cent said they had at least considered doing so
  • A quarter (26 per cent) of lesbian, gay and bi workers in all sectors are not at all open to colleagues about their sexual orientation
  • One in eight (13 per cent) lesbian, gay and bi employees in all sectors would not feel confident reporting homophobic bullying in their workplace
  • Nearly half (42 per cent) of trans people are not living permanently in their preferred gender role stated they are prevented from doing so because they fear it might threaten their employment status
  • One in five (19 per cent) lesbian, gay and bi employees in all sectors have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last five years
  • Almost a third of lesbian, gay and bi pupils are ignored or isolated by other people in educational environments
  • More than half (55 per cent) of lesbian, gay and bi pupils have experienced direct bullying in educational environments
Clearly, there is still a lot of work to be done, so that LGBT+ individuals can be treated with the dignity and respect that all individuals deserve. Due to the discrimination that LGBT+ people continue to face today, the Switchboard continues to run as the LGBT Helpline Scotland, offering to confidentially discuss a range of issues including sexuality, coming out, gender identity, relationships and sexual and emotional wellbeing with its callers. It functions as a part of Edinburgh’s LGBT Healthy Living Centre, which was set up in 2003 “to promote the health, wellbeing and equality of lesbian, gay, bisexual and transgender (LGBT) people in Scotland”, providing “support, services and information to improve health and wellbeing, reduce social isolation and stimulate community development and volunteering”. In 2006, the Switchboard also funded Remember When, an oral and community history project which documented the lives and achievements of Edinburgh's LGBT people, past and present. The project resulted in a series of recorded interviews, a book about the history of Edinburgh’s LGBT+ community, an archive held within the social history collections at Edinburgh’s Reminiscence Centre, and an exhibition at City of Edinburgh Council.

Friday, 21 April 2017

Case Note Cataloguing Continues ...

In this week’s blog Project Cataloguing Archivist, Clair, elaborates on LHSA’s newest case note cataloguing project.

As has been mentioned in a recent blog post, I am now working at LHSA through the University Collections Facility (UCF) Rationalisation project. This means I get to take forward the case note cataloguing skills that I have developed from working on our Wellcome Trust funded, Dott and TB projects to help open up other case note collections we hold at LHSA. After a trip to the UCF I was able to see the physical extent of LHSA’s case notes and this gave me a chance to properly scope the potential collections that could really benefit from being catalogued. The choices had already been narrowed down by LHSA Archivist, Louise, according to their size as it is important that within our project timeframe we complete cataloguing of an entire collection, opening it up to item level. This was a difficult choice to make as each potential collection from different time periods and medical specialities were wholly interesting within themselves. However, in the end I chose to work on Sexual Dysfunction case notes from the Gynaecological Out-Patient Department at the Royal Infirmary of Edinburgh (1973-1994) with around 1249 individual patient case notes to catalogue.

Fully re-housed Sexual Dysfunction case notes.

This is the most modern case note collection thus far to undergo cataloguing at LHSA but we are able to adapt our now well established case note cataloguing methodology to this different medical specialism. The methodology provides a template that allows us to capture a high level of detail from each individual patient record but also enables search functionality through the whole collection. It is flexible and therefore can be adapted to suit the specific characteristics of different medical specialisms. For example, I have decided to catalogue the type of medical treatments that were provided at the Sexual Dysfunction clinic in more detail than can be found in other case note catalogues. This is because the types of treatment were extensive and could be quite varied, from a course of sexual therapy to various urogenital surgical procedures. The Sexual Dysfunction case notes are also particularly interesting because the medical conditions of many patients are often linked to other physiological conditions or reflect on their social circumstances.

Of course, as with all other case note cataloguing projects we catalogue with the highest levels of confidentiality and patient records are closed according to appropriate dates under the Data Protection Act and Scottish Government guidelines on health information of deceased patients. However non-confidential information from the case notes will eventually be able to be accessed through an online redacted catalogue and provide a new way into another medical speciality.

Thoracic-Cardiac Surgery case notes before re-housing.
The project started in February and will run until July. Within this timeframe, we will have a lot of work to do but thankfully come next week I will be joined by our latest LHSA Intern for eight weeks, who will also be case note cataloguing. The internship aims to provide a recent archives graduate with experience in developing skills in cataloguing in the digital age and basic archival rehousing. Specifically, they will be cataloguing Thoracic – Cardiac Surgery case notes (1951-1958) that came from Dr Andrew Logan’s Thoracic Unit at the Royal Infirmary of Edinburgh. Unusually from our pervious case note cataloguing projects, which have always been beautifully rehoused for us before we begin cataloguing, this collections is in its original state. Therefore our Intern will be getting their hands dirty but will learn some important techniques about collection re-housing. Look forward to hearing more about our Intern and the work they will be doing in future blog posts!

Friday, 7 April 2017

Feminist Activism and Scotland's National Childbirth Trust

Our Skills for the Future Trainee will be sharing a bit about our National Childbirth Trust records with you this week…

Hi again, it’s Samar!

At LHSA we hold the archive for the Edinburgh branch of the National Childbirth Trust (NCT), which gives us an insight into women’s experiences of childbirth and maternity care from the early 20th century to the present day. I’ve been cataloguing this collection since January, particularly focusing on the labour reports written by Scottish mothers in the 1960s.

The NCT was founded by a woman called Prunella Briance in 1956. That year, Prunella had lost her baby during childbirth, and was outraged by the way she had been treated by hospital staff during this harrowing experience. As a result, she put an advertisement in The Times newspaper calling for mothers all over the UK to work together to prevent tragedies like this from happening again – and so the NCT was formed.

Our collection holds archive material such as committee minutes, correspondence, birth announcements, newspaper clippings, financial records, event timetables and articles and journals about natural childbirth. Significantly, the collection also holds labour reports written by Scottish mothers about their experiences of childbirth and hospital care. In many of these labour reports, women share unhappy stories of childbirth that ring true with Prunella’s experience.

NCT Committee Minutes Book 1965, featuring a child's drawing [Acc 13/045]

In the labour reports, we learn that many women had gas and air forced upon them against their will:

"I think I may have managed myself had it not been decided otherwise."

“[Hospital staff] told me I was getting too much oxygen from breathing technique - yet in the end had to give me oxygen."

“[I was] half doped throughout."

Babies were taken away from mothers right after giving birth:

"I was disappointed not to be given the baby after birth."

Women were left to labour for hours alone and without beds to lay in:

"I found I wanted to push, and was rather frantic as there were no beds free. All the nurses were very busy.”

Fathers were not permitted in labour wards, even if the mother requested they be allowed:

“… if only husbands could be at delivery."

Angered that so many women shared these experiences, the NCT organised educational classes that would provide expecting mothers with a network of peer support and information on childbirth that they couldn’t get anywhere else. The expectant fathers were heavily encouraged to attend classes with their partners, so that they could help and support the women as they prepared for birth.

The NCT’s classes aimed to make expectant parents better educated on what to expect during childbirth and also promoted natural childbirth techniques based on the teachings of Grantly Dick-Read. These teachings equipped the women with breathing exercises that would help them control their contractions, relax their muscles and get the oxygen they needed when giving birth. Many women also reported that these exercises helped them stay calm and focused during childbirth. Another reason why the NCT encouraged this method was because it helped the women avoid interventions such as inductions, episiotomies (cutting of the perineum) and enemas. This activism was particularly vital, as it was shortly publicised that some doctors were inducing women early during festive periods, to ensure that they wouldn’t have to work during that period.

NCT Committee Minutes Book (II) 1970-1982 [Acc 13/045]
Many women who attended the NCT’s classes reported that they felt relaxed during childbirth, that doctors and hospital staff greatly admired the method, and that in some cases, the women managed to avoid sedation and intervention. Some women even managed to convince staff to let fathers into the wards with them too:

"This nearness to my baby's birth gave me a special kind of excitement and I found that day very useful. I cleaned my house (again); I re-packed my cases (again); and most important of all, I read and read and re-read the sheets of notes I had collected over the months at my relaxation classes."

"... the nurses were very glad to see I was managing to control the contractions. One of them commented that she wished her sister, who was pregnant, could see how well I was managing. I had been trying to tell the other women in the labour ward (4 beds) about the breathing and by this time the ward sounded like a railway station with all the puffing and blowing."

"The pupil midwives were full of praise and said I had done very well. They enjoyed having (my husband) there and said he was a great help. He was given a cup of tea before me!"

"I didn't feel at all tired and would willingly have had another baby the next day."

"Alas, my difficult son decided to make his trip into the world with one hand on his head, which not only made the transitional stage rather painful, but rather hampered his actual delivery. Having said all this, I may say that I feel the training still made all the difference in the world..."

"Both the sister, who recognised the method - and a nurse who stayed with me gave every encouragement and were most impressed."

"Had I not trained under this method, I would have been overwhelmed by genuine pain in back and tummy. It could have been a ghastly time, but I was so glad I had practiced hard and read plenty."

"Midwife told doctor that due to attending breathing and relaxing classes, I was an excellent patient."

"I seem to have rambled on and on but I was pleased to write and tell you of the success of the method - as far as I am concerned. The Doctor said to me this morning that she was sure I wouldn’t have needed the gas and air if (the baby) had been of an average weight and that the nurses and herself thought the breathing was very helpful to them and I was completely relaxed from the waist down."

"It was only the knowledge of controlled breathing and also that I was well on that kept me in control."

The NCT continues to run today, campaigning to improve maternity care and ensuring that better information, services and facilities are provided to new parents. In April 2010, they joined a campaign calling for companies producing baby bottles to stop using Bisphenol A (BPA), a chemical that could leach out of plastics into food or liquid in tiny amounts and be absorbed by the body. The NCT also had a strong influence on The Equality Act, which now gives women in Britain the right to breastfeed in public without being discriminated against. They have also repeatedly lobbied for improved parental leave, supporting campaigns for increased paid maternity and paternity leave.