Friday, 16 June 2017

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.

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