Friday, 28 November 2014

Occupational Therapy: history behind the photographs

As I am coming to the end of my ten week internship at LHSA, working on the photograph collection, I have come across a selection of photographs from the Royal Edinburgh Hospital (REH) that led me to do some further investigation. The following set of photographs show patients from the REH carrying out activities in occupational therapy (OT). OT, in principal, endeavours to improve mental and physical health by providing practical support and activities, for individuals suffering from a wide range of conditions. OT helps individuals apply themselves in practical activities, from day-to-day tasks, such as preparing meals, to work and leisure.  This helps to bring purpose to people’s lives and helps them to live as independently as possible, which plays a key role in rehabilitation and helping the recovery of many health related conditions. Improving general outlook and well-being are also key concepts of the role of occupational therapy.[1]

A garden created by the patients at MacKinnon House over the past few years and now maintained by them, P/PL7/P/068

Keep fit class, P/P7/P/066

Whilst the roots of the development could be arguably traced back to China in 2600 BC, when Cong Fu was taught as “medical gymnastics” where physical training was believed to promote health[2]; I decided to try and track the developments at a more local level. It was not until around the eighteenth century that new approaches were beginning to take shape in the treatment of psychiatric patients by founding fathers, such as French physician Philippe Pinel, in moral treatment. This was a more humane approach to treatment of the mentally ill that preferred the use of practical therapy over incarceration or punishment. In his book published in 1801 Pinel prescribes, “physical exercises and manual occupations” for mental illness because “rigours executed manual labour is the best method of securing good morale discipline. The return of convalescent patients to their previous interests, to the practice of their profession, to industriousness and perseverance have always been for me the best omen of finial recovery”.[3]  Whilst OT was also evolving in the treatment of physical conditions, it was this relationship between OT and the treatment of mental illness, where some pioneering work was demonstrated in Edinburgh hospitals. 

An important recent development is the introduction of industry into the hospital through the co-operation of outside firms, P/PL7/P/065

A cooking lesson, P/PL7/P/067

Dr D.K. Henderson (1884 – 1965) was a Scottish born physician. He was a Physician Superintendent of the REH and a Professor of Psychiatry, through the hospital’s links with the University of Edinburgh.  The pictures from this collection would have been taken at a much later date, from Dr Henderson’s time at REH but they demonstrate some of his founding work there. A balance of farming, gardening work, as well as domestic and craft activities tailored to the patient’s condition, are examples of OT that he believed could, “increase a person’s self-esteem [due to the] ability to accomplish something”.[4] These sorts of activities could also create structure and organisation to a patient’s day, creating a balance between work, rest and play. Henderson believed this ultimately helped individuals adapt and removed feelings of hopelessness. By 1932 he had encouraged the founding of the Scottish Association of Occupational Therapy. 
Instruction in typing P/PL7/P/061

A corner of the farm, P/PL7/P/062
For individuals suffering from more physically debilitating conditions, OT was also being encouraged as a form of treatment. Casualties resulting from the First World War saw many men facing adapting back into civilian life with debilitating injuries and a lack of employment support. Curative workshops were opened within military hospitals, based on similar workshops already established in the United States, and were equipped with tools and machinery to exercise joints and muscles. Application in work based tasks could, therefore, help in physical healing and strengthening help but also in rehabilitating into society with permanent disabilities. Based on these workshops the first occupational therapy department in Scotland was opened in 1936 at the Astley Ainslie Institution in Edinburgh. The Astley Ainslie grew from being a convalescent hospital to become a leading rehabilitation centre and school for training occupational therapists.

An important recent development is the introduction of industry into the hospital through the co-operation of outside firms, P/PL7/P/064

Brush up your baking, P/PL7/P/063

From these early days of establishing the role that OT could play in improving health and wellbeing, we can see that as the profession has grown, it is still very relevant in society today.

[1] College of Occupational Therapists:  Last Accessed 27/11/14.
[2] Hopkins, H. An Historical Willard and Spackman’s Occupational Therapy (Sixth Edition, USA:1983), p. 3.
[3] Ibid, p. 4.
[4] Creek, J. Occupational Therapy and Mental Health (Elsevier:2008), p.9.

Friday, 21 November 2014

‘Thought is the Seed of Action’… Neurosurgery on screen

This week's blog is from Liz, our Project Cataloguing Archivist on our Wellcome Trust -unded case note cataloguing project.
A letter I came across this week, while continuing with my cataloguing of Norman Dott’s neurosurgical case notes, led me to looking into a ground-breaking  (and somewhat controversial) BBC television series, ‘Your Life in Their Hands’. The letter was from a former patient of Dott’s who had been successfully treated by him and his team in the Department of Surgical Neurology at the Royal Infirmary of Edinburgh in 1954. She opens her letter by referring to his appearance on the BBC series broadcast on 11 March 1958. Dott’s reply is also contained in the case note, ‘How kind it was for you to write on the occasion of our Departmental Broadcast. It was quite interesting to consider what would interest people and the split-second technical side of it was quite an experience’.

The series featured ten programmes each looking at a different medical condition and how it was treated. Each of the programmes came from different hospitals around Great Britain, and in Dott’s case the focus was the treatment of head injuries in the Department of Surgical Neurology at the Royal Infirmary of Edinburgh and Bangour Brain Injuries Unit. Other episodes featured the treatment of conditions including respiratory paralysis following poliomyelitis, tuberculosis, rheumatic fever and mitral stenosis. The broadcasts were presented by Dr Charles Fletcher and aimed to provide clear information to the public about medical conditions and the modern techniques being used to treat them. What made the programmes so notable was the inclusion of footage of surgical operations taking place.

BBC filming of an operation at the Western General Hospital, GD28/8/2/10
The episode featuring Dott was entitled ‘Thought is the Seed of Action – a look at neurosurgery from the Royal Infirmary of Edinburgh’.  Fortunately we have a copy of the transcript for the programme in our collections, as well as a VHS recording (which I look forward to watching at a later date). The broadcast opens with Dr Fletcher introducing the subject and then handing over to Professor Dott who describes the Royal Infirmary as a general hospital that ‘deals with all the ills that flesh is heir to’ and he makes sure to credit all the staff at the Hospital with the valuable work done there, ‘Nor would our work be at all possible without our nurses and our large background staff’. Several members of the Surgical Neurology team also feature in the broadcast including Dr F J Gillingham, Dr Kate Herman, and Mr Philip Harris, with Mr Harris describing the brain as a ‘complex organ’ which can be compared to ‘the BBC and a vast telephone exchange. Messages are constantly coming into it – and are being received, interpreted, recorded as memories and messages are constantly being sent out to other parts of the body’. The programme looked at how patients were assessed, treated and their rehabilitation, with a focus on the treatment of a young man who sustained a head injury while playing football. As a result of his injury he developed a blood clot which is shown being operated on by Dott and his team. The programme signs off with a warning to motorcyclists about the importance of wearing crash helmets. The inclusion of Dott’s Department in the series was testament to the important work they were carrying out. 

Transcript of 'Your Life in Their Hands'

‘Your Life in Their Hands’ was met with a mixed response, on the whole well received by the public and press, with the exception of the British Medical Journal, who were opposed to the series and who published several articles about it in 1958. They believed the series would heighten public fears of illness and increase hypochondriasis. The discussion even made it into the House of Commons with a question being raised on 26 February 1958 about the potential ill effect the programmes may have on the public. Despite the initial unease felt  at the candid and graphic depictions of medical treatment in 1958, ‘Your Life in Their Hands’ was a huge success with further series being made over the last 50 years and the presence of medical documentaries on television becoming commonplace now.

For more information see:
M. Essex-Lopresti; “The 50th anniversary of ‘Your Life in Their Hands”, J. Vis. Commun. Med., vol 31 no.1, March 2008:36-42

Friday, 14 November 2014

Explore our Archive

Today, we’re coming to the end of Explore Your Archive week, an initiative from the Archives and Records Association that aims to raise the profile of archives and their role in our everyday lives. Archives can risk being seen as dusty and irrelevant, telling us about the past but with little relevance to how we live our lives now. In Explore Your Archive week, we need to say very much the opposite – archives not only preserve our memories, but also act as vital evidence for the present and future to ensure that our society is run openly and fairly.

Climbing off my soapbox for a minute, we have been having some serious fun in Explore Your Archive week! We’ve been taking part on Twitter, joining together with archivists from across the United Kingdom and Ireland (and also worldwide!) who have been tweeting on a different theme every day.

Monday was an insight into a #DayInTheLife of archivists, peeking into what archivists get up to all day in the office and amongst the stacks in the stores. From work in the search-room to cataloguing to taking part in talks and lectures, a great variety of activity was on show. It had been an enquiries day for me, seeking out images like this one...

At work in the Royal Edinburgh Hospital hen house, April 1959 (P/PL7/P/038) well as researching people’s ancestors though our asylum records. The case books of the Royal Edinburgh Hospital are not our largest collection, but they are certainly the most popular with researchers.

On Tuesday, First World War archives were the focus (#ww1archives). This year, we’re getting a  lot of enquiries about the period for obvious reasons. Although we can’t help people with soldiers’ medical records, we have a wealth of sources giving a glimpse into everyday life in Edinburgh’s hospitals during the war, including nurses’ scrapbooks like this one from Bangour Village Hospital (taken over by the War Office in 1915):

Scrapbook from a Bangour nurse, c. 1917 (Acc13/044)

Wednesday saw a chance for Twitter followers to #askarchivists. Although I didn’t take any questions myself, queries ranged from oldest archives to guides to academic and genealogical research. And don’t worry if you didn’t get your question in on the day, because as one participant said: “Archivists don't just answer questions one day a year! We do it all day, every day!”

We took an #archiveselfie on Thursday – here are our wonderful CRC conservators, posing with their favourite equipment:

Our CRC conservators, left to right: Emma, Ruth, Anna and Emily.
My own favourite 'selfie story' was that of Edith Halvarsson, who’s been with us from the Information Management and Preservation MSc at the University of Glasgow. In two weeks, she’s very much explored archives and taken the papers of the Medical Women’s Federation from this:

Medical Women's Federation papers before cataloguing

To this:

Edith with a beautifully ordered trolley!
As the ‘mad cat lady’ of the office, I’m ready to post pictures of our #archiveanimals today (cats and dogs, for example, can often be found in both informal and formal images of hospital staff). Here’s one with First World War soldiers recuperating with the help of some feline friends at Edenhall Hospital for Limbless Sailors and Soldiers:

First World War image from a photograph album from Edenhall Hospital, c. 1917 (Acc12/054)
The Explore Your Archive initiative doesn’t end today for LHSA. Worth a mention is our participation in the Previously… festival over the next couple of weeks. The Previously... festival celebrates Scotland’s history with events all over the country. On Saturday 15 November, we’ll be at the Family History Day in Edinburgh Central Library on George IV Bridge (and tweeting, with the hashtag #explorearchives). From 10:30am until 4pm, you can come along and ask Ruth and Louise everything you’ve ever wanted to know about finding family history in hospital records.

On Tuesday 18th November here at the Centre for Research Collections, Louise is going to be talking about how to use our records in genealogy, with a chance to get up close and personal with some of our nineteenth century patient records:

And on Saturday 22nd November, we’re running a children’s event on making your very own medieval manuscript!

We need to speak up for and use archives to keep them alive, so come and visit LHSA at these events – and Explore Our Archive!

Friday, 7 November 2014

Exploring LHSA's photographic collection

I am currently the LHSA intern and I am at the halfway point of my main task of cataloguing the vast and varied photographic collection.  As a (very) newly qualified archivist, this has been such a great opportunity for me to work full-time and engage with the skills that I have developed over the last year.  As I volunteered with LHSA throughout gaining my qualification, I have equally enjoyed becoming part of the team, including the glorious views of Edinburgh from my desk and copious amounts of home-baking at tea break. 

My main task has been to bring all of the LHSA photographic collection under the same system to ensure maximum access to over 6000 photographs, documenting many aspects of the development of medicine and hospitals from the mid-nineteenth century.  From the photographs that I have been working with thus far, I would like to share with you some of my favourites and others that I have found rather interesting. 

This photograph is from c. 1879-1910 and is a view of the Royal Infirmary of Edinburgh, Lauriston Place, from the Meadows, with sheep grazing in the foreground.  Whilst it is a lovely image of the grand hospital, I was rather surprised to see sheep.  As a student I often enjoyed spending hot and sunny days at the Meadows but I am not sure how students nowadays would feel sharing it with these woolly beasts.
Moving on, some of the photographs have been really interesting in their depiction of medical treatments.  I have been learning about ‘sunlight treatment’ from this picture taken c. 1930 - 1950 at Deaconess Hospital. This is a photo of a child lying on an operating table being exposed to bright light with two seated children and a nurse standing at the side, all wearing protective goggles.  What would certainly be a controversial treatment now was in fact a regular treatment for many children and adults between 1920 and 1950.  The artificial light lamp was invented by Niels Ryberg Finsen and was thought to be of most benefit to those suffering from tuberculosis of the skin.[1]  

This is a photograph from the very early days of using x-ray to diagnose patients, around 1900.  William Law is pictured here wearing protective clothing and radiography apparatus.  Law was one of the first radiographers at the Royal Infirmary of Edinburgh, which opened a ‘Medical Electrical Department’ in 1889.  The protective clothing is particularly distinctive and highlights the dangers of this type of work in the early days of its use.

Finally, the LHSA photographic collection has an excellent selection of portrait photographs of Edinburgh medical greats working as physicians, surgeons, nurses and as other medical practitioners.  In keeping with the theme of pioneering radiology in Edinburgh here is a portrait of Robert Knox, d. 1928.  Knox was Consultant Radiologist at Chelsea Hospital for Women, but his work in treating cancer with x-rays played a major role in setting up the new Radiological Department of the Royal Infirmary of Edinburgh in 1926.[2]  Whilst he is certainly not the most famous ‘Robert Knox’ associated with medicine in Edinburgh, it has been nice to highlight the positive advances this Knox brought, in comparison with the notorious Robert Knox associated with the Burke and Hare murders.   
I look forward to the rest of my time working with the photographs at LHSA and hope to find more unique images from this exciting collection.