Bullitt Lecture on Poverty-Disease Link in Washington, D.C.

The next noontime meeting of the Bullitt History of Medicine Club will be Monday, April 6, 2009 at the UNC Health Sciences Library in the 5th Floor Conference Room (527). Please join us from 12-1pm for light refreshments and lecture. Meetings are free and open to the public.

Lisa Wiese, second-year medical student at UNC School of Medicine, will be presenting a lecture entitled, “Washington, D.C.: Understanding the Poverty-Disease Link from an Historical Lens.”

The talk will give an historical perspective on why certain Washington, D.C. neighborhoods have high rates of concentrated poverty. Lisa will also be talking about how economic marginalization impacts the health of city residents, and what is being done to address the poverty-pathology link in the district.

Visit the Bullitt Club web site for further information on club activities; Bullitt lectures for 2008-9 are now available online as mp3 downloads.

Professor Oliver Smithies on the Scientific Record

Nobel laureate and UNC Professor Oliver Smithies delivered a fascinating array of observations on his life in science at the Health Sciences Library on March 30, 2009. The event was moderated by Dr. Tony Waldrop, UNC Vice Chancellor for Research and Economic Development, and featured a conversation with Smithies and a lengthy question-and-answer with the audience, which was composed of numerous students, researchers, staff, and faculty, as well as members of the public.

Smithies emphasized the vital importance of seeking out original literature to be able to trace the intellectual development of scientific ideas. He noted further that while access to current and historical literature is ever-increasing, information technologies are not without attendant risks and limitations. The rapid obsolescence of various media, particularly digital formats, presents a long-term preservation and access problem.

In his own work spanning decades, Smithies has assiduously compiled series upon series of laboratory notebooks in which he has recorded the trials, tribulations, and remarkable discoveries of his countless experiments. In fact, Smithies' Nobel Lecture, entitled "Turning Pages," featured his notebooks prominently (this lecture and other Nobel-related materials--audio, video, and texts--are accessible at the Health Sciences Library web site). Smithies pointed out that information, data, and ideas recorded in written form have an immediacy and ongoing functionality not exhibited by other examples of storage media that he brought along from his personal archives.

Those interested in learning more about Smithies' talk can read The Daily Tar Heel article, "Smithies Emphasizes Importance of Records." And for those curious about how the wisdom of Professor Smithies might be rendered in 140-character tweets on Twitter, check out UNC Professor Paul Jones' numerous postings made during the event. Smithies himself, needless-to-say, does not twitter, but UNC HealthCare, for example, does.

The UNC Health Sciences Library videoed the entire event, and will make this available online at a later date.

Pandemics, Infectious Diseases, and Public Policy

Engage in discussion with UNC-Chapel Hill scholars, researchers, and clinicians—four Thursday evenings, 7–9 pm, beginning April 2 at the Friday Center. What's the Big Idea? is presented by the Friday Center in partnership with Endeavors Magazine. Advance registration is required. Lectures are $10 each or all four for $30; further information is available online.

Spring 2009: Pandemics, Infectious Diseases, and Public Policy
Join us for four evenings of lectures by eminent UNC-Chapel Hill scholars and researchers to examine a topic that deserves serious focus in an ever-shrinking world. Infectious diseases can have small-scale local consequences as well as global effects. How is the medical community responding to research and the public’s need for knowledge and treatment? Are emergency management teams prepared? Are public policies in place to deal with a pandemic? Learn what UNC-Chapel Hill is doing to address these issues.

:: The Global HIV Pandemic 2008: Where Do We Go From Here?
Thursday, April 2, 7–9 pm

Thirty-six million people are living with HIV; sixteen million have died from the disease. Eighty percent of the HIV epidemic is in sub-Saharan Africa, and as many as one-third of adolescent girls in South Africa have acquired HIV by age 21. Why is the disease focused in this geographic location, and what are we doing about it? This presentation considers the global HIV pandemic with a focus on the disease in Africa and possible approaches to stopping the devastation of HIV.

Myron Cohen is associate vice chancellor for Medical Affairs-Global Health and director of the UNC Institute for Global Health and Infectious Diseases.

:: Social Forces and the HIV Epidemic: Why Some People Get HIV and Others Don't
Thursday, April 16, 7–9 pm

Poverty, incarceration, and segregation are some of the economic and social forces that disproportionately impact African Americans. This presentation will examine the ways that social and economic forces affect the distribution of HIV in the US population.

Ada Adimora is professor of medicine at the UNC School of Medicine and adjunct professor of epidemiology at the UNC Gillings School of Global Public Health.

:: Geographical Analysis in Vaccine Trials: Concepts and Case Studies
Thursday, April 23, 7–9 pm

Trials are the gold-standard tool for evaluating the effectiveness of vaccines. However, some people question the utility of conventional vaccine trial methods, arguing that it is difficult to make decisions about whether or not to vaccinate diverse populations because, due to different social and environmental circumstances, vaccines might work better in some areas than others. This presentation will introduce “ecological vaccine trials,” which use geographical analysis to determine the circumstances in which a vaccine will work best. Case studies, including the trials for cholera and malaria vaccines, will be used to guide the discussion.

Michael Emch is associate professor of geography at UNC, a Fellow at the Carolina Population Center, and adjunct associate professor of epidemiology at the UNC Gillings School of Global Public Health.

:: Emerging Infections and Biodefense: Are We Doing Too Little or Too Much?
Thursday, April 30, 7–9 pm

This presentation will examine the national and regional response to the anthrax attacks of 2001. Now that we strongly suspect that the perpetrator of these attacks was a US scientist, many worry that a massive post-2001 increase in research intended to prevent or treat attacks with infectious diseases could paradoxically increase our risk of attacks from within. Are these fears justified? How do we protect ourselves against “rogue” scientists? Are there risks (the “dual use” problem) in conducting research on biodefense? How can we protect ourselves from dual-use threats? We also are increasingly aware of naturally emerging threats to our health that respect no geographical borders, including drug resistant tuberculosis and staphylococci, and a plethora of viruses. How great are the risks? What should be our responses to them? What is the proper balance between biodefense research and emerging infections research in an era of financial limitations?

Fred Sparling is professor of medicine and microbiology and immunology at the UNC School of Medicine and director of the Southeast Regional Center for Excellence in Biodefense and Emerging Infections.

Military Medical Photographs Online

The National Museum of Health and Medicine has mounted a growing collection of archival photographic images on Flickr. Grouped at present into 30 different sets, the online images are just a small portion of the Museum’s collection of several hundred-thousand images. More information on the collection is available in a recent Wired Magazine blog posting.

The Museum began as the Army Medical Museum during the Civil War in 1862 and assumed its present name in 1989. It is an element of the Armed Forces Institute of Pathology, and its holdings are divided into five main areas: Historical Collections; Anatomical Collections; Otis Historical Archives; Human Developmental Anatomy Center; and the Neuroanatomical Collections.

Located on the campus of the Walter Reed Army Medical Center in Washington, D.C., the Museum has an active exhibition program and sponsors various events. The Museum also publishes a newsletter, Flesh and Bones, which is available online. A group of Museum employees maintains an unofficial blog, A Repository of Bottled Monsters, with news of Museum activities.

The image above, depicting US Army Nurses serving at the 1st Reserve Hospital in Manila, the Philippines, was obtained from the Museum's Spanish-American War set on Flickr.

The Bicentennial of Louis Braille [1809-1852]

Besides being the bicentennial of the births of such luminaries as Charles Darwin, Abraham Lincoln, and Edgar Allen Poe, 2009 is the two-hundredth anniversary of the birth of Louis Braille [1809-1852], the creator of the ingenious braille system, which has given countless blind and vision-impaired people the ability to read and write. Braille utilizes a six-dot cell of raised dots to represent letters of the alphabet, numerals, punctuation, and other symbols. Permutations of the six dots permit the representation of 64 different characters, and the system has been adapted to numerous different languages around the world. The compactness of each cell allows individual cells to be read without unnecessary movement of the fingertip—a weakness of earlier systems.

Braille first described his system in a 32-page booklet published in 1829 entitled, Procede pour écrire les Paroles, la Musique et le Plain-chant au moyen de points, a l’usage des Aveugles et dispose pour eux [Method for Writing Words, Music, and Plainsong by Means of Points, for the Use of the Blind and Arranged for Them]. Images of this rare work are viewable on the web site of the bookseller, Jonathan A. Hill.

To commemorate Braille’s contributions and promote literacy among the blind, the US Mint is issuing a one-dollar silver coin (pictured above) on March 26, 2009. The obverse of the coin features a portrait of Braille and the reverse depicts a child reading a book in braille with the word "braille" (abbreviated as BRL) above him--the first time a US coin has employed braille--and the word "independence" on a bookshelf behind him.

According to the National Federation of the Blind, only 10% of blind children in the United States are learning braille. Among working-age, legally blind adults, over 70% are unemployed, although among those who are successfully employed, a large majority know braille. For further information, visit the NFB web site, which offers resources on braille literacy and an extensive audio & video selection, including a video on the commemorative coin, Change with a Dollar.

Additional online resources of interest include the National Braille Press and the Louis Braille Bicentennial web site. The National Braille Press has also recently published the biography, Louis Braille: A Touch of Genius, that contains previously untranslated letters by Braille. The National Library Service for the Blind and Physically Handicapped, based at the Library of Congress, is a national network that distributes braille and audio materials to eligible borrowers.

AAHM and the Future of Medical History Libraries

The February 2009 issue of the AAHM Newsletter published by American Association for the History of Medicine is now available online, and contains the president's message ("The AAHM and the Future of Medical History Libraries"); AAHM news, including the upcoming conference in Cleveland; notices on members, fellowships & grants, meetings & calls for papers, lectures & symposia, and archives, libraries, and museums (including a brief notice on Special Collections at HSL; see page 21). Earlier issues of the AAHM Newsletter are also archived online.

In the above-noted president's message, W. Bruce Fye quoted a presentation he made in 1982 to the Archivists and Librarians in the History of the Health Sciences organization; given the current economic situation across the state and country, his observations seem especially relevant still today:

“In a given institution,” I argued, “there may be one or two faculty members or administrators who are sensitive to the needs of the history of medicine collection and those individuals charged with its care. This is obviously a precarious situation. Should the supportive dean or faculty person retire, move to another institution or expire, the history of medicine collection may lose a vital friend or patron.” I concluded, “The unique institutional resource you administer must be preserved and its value acknowledged. Administrators within your library or institution may question the relevance of historical materials in this age of financial uncertainty. By forming a coalition among interested individuals of diverse backgrounds and by heightening the awareness of those within your institution and community to the contents of your collection you can most likely survive and perhaps even thrive in this challenging decade.”

In response to such concerns, Fye created the Ad Hoc Committee on the Future of Medical History Libraries to address the following questions, among others:

1) How important is it that the few remaining major medical history libraries be preserved for the benefit of future scholarship in the history of medicine?
2) What research opportunities are lost when comprehensive collections are dispersed?
3) What types of printed materials are not being captured electronically?

Committee members will work to generate a report to the AAHM Council by September 1, 2009.

Oliver Smithies at UNC Health Sciences Library

A Conversation with Dr. Oliver Smithies
UNC Excellence Professor of Pathology and Laboratory Medicine
2007 Nobel Laureate

Moderated by Dr. Tony Waldrop
UNC Vice Chancellor for Research and Economic Development

Monday, March 30, 2009
4:00 pm - 5:30 pm

UNC Health Sciences Library, Room 527
Light refreshments to follow

Join us for a chat with Dr. Oliver Smithies about the importance of access to scientific research and information. Audience participation will be encouraged. Don't miss this opportunity to have your questions answered by Dr. Smithies. You may also submit questions for Dr. Smithies when you register to attend.

Space is limited and registration is required. To ensure your seat, register today!

HSL will also make a video of this discussion with Dr. Smithies available online at a later date.

-- Information on Dr. Oliver Smithies
-- Information on Dr. Tony Waldrop
-- Carolina's ties to the Nobel Prize

For a collection of online materials related to Smithies' Nobel Prize, visit the Special Collections Highlights web page.

Women's History Month 2009

On March 3rd, President Obama issued a proclamation for Women's History Month, declaring this year's theme to be "Women Taking the Lead to Save Our Planet." In this document are cited several women who have exemplified great leadership in this area, including:

Ellen Swallow Richards [1842-1911] -- the first woman accepted into a scientific school in the US, Richards graduated from MIT in 1873 and pioneered the assessment of water quality. The UNC Health Sciences Library has several of her works.

Rachel Carson [1907-1964] -- marine biologist, ecologist, and author; Carson's classic book, Silent Spring (1964), galvanized the American public concerning pesticides and other environmental dangers.

Grace Thorpe [1921-2008] -- a tribal judge for the Sac and Fox Nation and activist for tribal sovereignty, Thorpe opposed the dumping of nuclear waste on Native American lands; her father was the famed Olympic athlete Jim Thorpe.

Works by and about women figure prominently in Special Collections at UNC Health Sciences Library; two notable examples are:

Florence Nightingale [1820-1910], known as the “Lady with the Lamp” for her service during the Crimean War, was a pioneering nurse, statistician, author, and educator. In 1860 she opened the Nightingale Training School for Nurses in London, for which her book, Notes on Nursing (1859), served as the cornerstone of the curriculum. Several of her handwritten letters from Special Collections have been digitized and are available online; many of her published works are also available in the library.

Closer to home, Susan Dimock [1847-1875] of Washington, North Carolina, was a pioneer among women physicians in America. Denied access to medical education, she pursued her studies abroad, graduating from the University of Zurich in 1871; her dissertation on puerperal fever, written in German, is available online as part of the International Theses Collection at HSL. In 1872, Dr. Dimock was appointed the resident physician of the New England Hospital of Women and Children, and played a key role in developing a formal training program for nurses. This same year she was granted honorary membership in the Medical Society of the State of North Carolina--it's first female member.

Lastly, March 8th is International Women's Day. Although often overlooked in the United States since its inception in 1911, it is recognized and celebrated in many countries around the world.

2009 Annual Meeting of the American Association for the History of Medicine

Registration is now open for the annual meeting of the American Association for the History of Medicine (AAHM), which will be held in Cleveland April 23-26, 2009. The AAHM web site has the full conference program and online registration. Membership dues are $85/year for individuals and $25/year for students.

AAHM is the leading organization for the history of medicine in the U.S., and affiliated groups also schedule their annual meetings to coincide with the AAHM conference. This year the American Osler Society, the Medical Museums Association, the Sigerist Circle, the Society for the History of Navy Medicine, the History of Psychiatry Discussion Group, as well as the Archivists and Librarians in the History of the Health Sciences will all be meeting in Cleveland (see AAHM program or organization web sites for further information).

Lastly it is worth noting that several UNC faculty and students will be presenting at the meetings of the AAHM and the American Osler Society; the titles of their respective presentations are listed below. Drs. Jeff Baker and Margaret Humphreys of Duke will be moderating panels at AAHM.

AAHM:

Michael McVaugh, Ph.D.
The Meaning of “Salernitan” in Thirteenth-Century Medicine

Katherine Keirns, College of Arts and Sciences
Lungs and Laces: Spirometry & the Quantification of Women’s Breathing in the 19th Century

American Osler Society:

H. Mike Jones, M.D.
Pellagra, Progress, and Public Polemics: Goldberger, E.J. Wood, and the Osler Connections

Jamie Fraser, 3rd-Year Medical Student
William B. Bean Student Research Award Lecture
Molding an Independent Specialty: Plastic Surgery in Postwar America

"Open Stacks" at UNC's Wilson Library

On February 17, 2009, curators and staff at Wilson Library sponsored "Open Stacks," giving the public the rare opportunity to go behind the scenes and view materials drawn from the Southern Historical Collections, the Southern Folklife Collection, and the University Archives and Records Service. The student newspaper, the Daily Tar Heel, was on hand to record some of the tour, and this can be seen in the YouTube video below.

New Wendy Moore Biography on Mary Eleanor Bowes

Wendy Moore, journalist and author of The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery, has just published a new biography entitled: Wedlock: The True Story of the Disastrous Marriage and Remarkable Divorce of Mary Eleanor Bowes, Countess of Strathmore.*

Moore delivered a delightful and erudite Bullitt Club lecture on John Hunter on September 23, 2008 (see Bullitt web site for an MP3 recording), and her biography is equally so. The subject of her new book was born 260 years ago, on February 24, 1749, and was a friend and patient of Hunter's. Wedlock opens with a scene of swordplay, and is just as intriguing throughout; as described on her web site:

'Wedlock' tells the remarkable true story of Mary Eleanor Bowes, Countess of Strathmore, who became Britain's richest heiress on the death of her entrepreneur father when she was 11. After an unhappy first marriage to John Lyon, the 9th Earl of Strathmore, who left her a widow when he died of TB, she was lured into marrying an Irish fortune-hunter named Andrew Robinson Stoney. Squandering her money and laying waste her vast estate, Stoney--who adopted the surname Bowes on marriage--reduced Mary to a wretched, starved, petrified shadow of her former self. After suffering eight years of cruelty and torment, Mary Eleanor finally found help in the most unlikely of places. A barely credible tale of survival and triumph against overwhelming odds, 'Wedlock' reveals an eighteenth-century world of sexual intrigue, terrifying adventure and court room drama.

* As a bibliographical note, the American edition of Moore's Hunter biography is entitled: The Knife Man: Blood, Body Snatching, and the Birth of Modern Surgery. The UK edition of the Bowes biography is entitled: Wedlock: How Georgian Britain's Worst Husband Met His Match.

Edward Tufte on Presenting Data and Information

Edward Tufte, a leading authority on the design and use of data and information, will be offering his one-day workshop, Presenting Data and Information, on March 9th and 10th in Durham, NC. Courses fill quickly, so those interested in attending should register soon; further details can be found at his web site.

I attended one of Tufte's workshops a couple years ago in Phoenix, and would recommend it most favorably. His work is thoroughly grounded in the analysis of historical precedents, both good and bad, and he has also written on the presentation of information in medical contexts. His essay, The Cognitive Style of PowerPoint: Pitching Out Corrupts Within, is particularly incisive and should be required reading for all those who have come to rely on this software for conveying information. In short, Tufte is insightful and entertaining.

Participants receive copies of four of Tufte's books as part of the course fee: The Visual Display of Quantitative Information (second edition, 2001); Envisioning Information (1990); Visual Explanations: Images and Quantities, Evidence and Narrative (1997); and Beautiful Evidence (2006). All are well worth reading.

Topics covered in the course include:

-- fundamental strategies of analytical design
-- evaluating evidence used in presentations
-- statistical data: tables, graphics, and semi-graphics
-- business, scientific, research, and financial presentations
-- complexity and clarity
-- effective presentations: on paper and in person
-- interface design
-- use of PowerPoint, video, overheads, and handouts
-- multi-media, internet, and websites
-- credibility of presentations
-- animation and scientific visualizations
-- many practical examples

A Hearty Valentine's Greeting

This year's Valentine's message features a papier-mâché heart in Special Collections at the Health Sciences Library, which was purchased through the Dr. Benson Reid Wilcox Rare Book Endowment. Designed by Dr. Louis Thomas Jérôme Auzoux (1797-1880) and fabricated circa 1870, this and similar anatomical models were an important tool in the teaching of human anatomy in the nineteenth century. As cultural, legal, and environmental concerns limited the efficacy of using cadavers for instruction, Auzoux pioneered the development of papier-mâché anatomical models, which were employed to represent the structures of humans, as well as animals and plants. For those interested in learning more, the Smithsonian Institution's online exhibition, Artificial Anatomy: Papier-Mâché Anatomical Models, is highly recommended.

Other online resources on the anatomy and function of the heart are the Latin and English versions of William Harvey's Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus [On the Motion of the Heart and Blood in Animals], in which he famously observed in 1628:

" . . . it is absolutely necessary to conclude that the blood in the animal body is impelled in a circle, and is in a state of ceaseless motion; that this is the act or function which the heart performs by means of its pulse; and that it is the sole and only end of the motion and contraction of the heart." -- Chapter 14, "Conclusion of the Demonstration of Circulation" (translated by Robert Willis).

Black Medical History Resources

:: The Old North State Medical Society (Durham, NC)
The nation's oldest association of black physicians, the Society was founded in 1886 and has from that date until the present directed its energies to the objectives of equity in healthcare, equal opportunity for black professionals and equal care for black, other minorities, and very poor patients. Online exhibit at: Virtual Museum of African American Medical History in North Carolina

:: Black History Month: A Medical Perspective (Duke)
An online exhibition featuring sections on People, Medical Education, Hospitals, Folk Medicine, Chronology of Achievements, as well as a Selective Bibliography.

:: Opening Doors: Contemporary African American Academic Surgeons (National Library of Medicine)
African Americans have always practiced medicine, whether as physicians, healers, midwives, or “root doctors.” The journey of the African American physician from pre-Civil War to modern day America has been a challenging one. Early black pioneer physicians not only became skilled practitioners, they became trailblazers and educators paving the way for future physicians, surgeons, and nurses, and opening doors to better health care for the African American community.

:: Journal of the National Medical Association (1909 to present)
In celebration of Black History Month, the National Library of Medicine has announced an important addition to PubMed Central (PMC), its free digital archive of full-text journal articles: the complete archive of the Journal of the National Medical Association (JNMA), which observes its centennial this year.

The National Medical Association (NMA), established in 1895, is the largest and oldest national organization representing African American physicians and allied health professionals in the United States. The JNMA was published quarterly from 1909 to 1938, bimonthly from 1940 to 1977, and monthly since 1978. The archive currently represents over 77,000 digitized pages of issues through 2007. More recent content will be coming at a later date.

Bullitt Lecture on Early Black Physicians

The next joint meeting of UNC’s Bullitt History of Medicine Club and Duke’s Trent History of Medicine Society will be Tuesday, February 10, 2009 at the UNC Health Sciences Library in the 5th Floor Conference Room (527). Please join us at 5:30pm for light refreshments followed by the lecture at 6pm. Meetings are free and open to the public.

Dr. Todd Savitt, Professor of Medical Humanities at East Carolina University, will be presenting a lecture entitled, "Entering a 'White' Profession: Black Physicians in 19th- and 20th-Century America."

Dr. Savitt is an historian of medicine. He received his bachelor's degree from Colgate University (1965), attended the University of Rochester School of Medicine (1965-1968), and earned his M.A. (1970) and Ph.D. (1975) in history from the University of Virginia. After teaching history of medicine and medical humanities at the University of Florida College of Medicine from 1976 to 1982 he joined the faculty of the Department of Medical Humanities at East Carolina University School of Medicine, where he presently teaches history of medicine, literature and medicine, social and cultural issues in medical practice, and medical ethics.

Dr. Savitt's primary research interests are African-American medical history and medical history of the American South and West. He has written or edited six books (Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia; The Dictionary of American Medical Biography; Science and Medicine in the Old South; Disease and Distinctiveness in the American South; Medical Readers’ Theater: A Guide and Scripts; and Race and Medicine in Nineteenth- and Early-Twentieth Century America) and a number of articles on such topics as the relationship of the AMA towards black physicians, history of sickle-cell anemia, sudden infant death syndrome (SIDS), use of African Americans for medical experimentation, the entry of black physicians into the American medical profession, and early African-American medical schools and medical journals.

For directions to the UNC Health Sciences Library, visit the HSL website. The Robertson Scholars Express Bus travels non-stop between UNC (Morehead Planetarium) and Duke (Chapel Circle).

For more information on the Bullitt Club and a schedule of meetings for spring 2009, please visit the Bullitt website. Bullitt lectures for 2008-9 are now available as mp3 downloads.