Friday 26 August 2016

Happy Birthday Professor Dott!

     Today would have been the birthday of the great neurosurgeon Norman Dott, born exactly 119 years ago on the 26th of August 1897 in Colinton, near Edinburgh. His work was crucial to the development of neurosurgery in Scotland; indeed he devised many advanced diagnosis techniques and performed pioneering surgical procedures. Plenty of examples can be found in the c. 28,000 case notes being catalogued under the project “Cataloguing Norman Dott's neurosurgical case notes (1920-1960)” – read more about the advancement of the project here. His collection contains a wealth of fascinating case summaries, drawings and photographs; however on this occasion I would like to present the man himself. We already have written about his life, but this article will try to give a glimpse of the man’s admirable character, especially in his relationship with his patients.   

Photograph of Norman Dott. (PR1.1536)

     Norman Dott was a very well-known and appreciated figure in his city. His colleagues recognised the excellence of his work and his patients were proud to have been treated by him. He would often leave a lasting impression on people, and when a biography was tentatively mooted 15 years after his death, countless letters and phone calls from people who had met him in person poured in. Some of the features that stand out the most are his kindness towards his patients and his sincere interest in them. It is clear when one reads his case notes that Norman Dott really sought to know his patients, their work, their family, their fears and their aspirations. He would take the time to explain to them the nature of their conditions, the treatments available to them, or what they could expect in the future. We can quote here the letter of a father who had arranged for his son, who suffered from a ‘slow mental development’, to be seen by Dott through a common friend: 

      ‘Mrs … and I do… deeply appreciate the courtesy and kindness you have shown us in reading and commenting on my notes in spite of the informal manner of the approach to you, for this matter … is naturally one of the gravest anxiety to us’;

     ‘Again with many thanks for your kindly interest which in itself has been of considerable comfort to us’.

     The parents of this little boy were far from the only ones to express their gratitude to Norman Dott: indeed, it is not rare at all to find in the case notes letters sent by the patients to thank him, postcards greeting him for Christmas or New Year’s Eve, or even photographs of themselves or their child in good health after having been treated by him…Some patients would sometimes keep contact for many years. Norman Dott would always find time in his very busy schedule to personally reply to each of them, with kind words and a personalised attention.

Some photographs in Norman Dott case notes are more lighthearted than others...This child was seen by Dott in the late 30s. (PR4.14380)

A New Year card sent by a patient to thank Norman Dott for his care, with a wee poem! (PR2.1968)

     The correspondence and comments found in the case notes depict a man of great talent and of great compassion, determined to fight disease and always concerned for his patients’ well-being on the short and long term. Even when a treatment was unsuccessful, he wasn’t discouraged and always tried to learn from failure. In a letter relating to the case of a man suffering from a malignant astrocytoma who died despite having undergone an operation, he writes: ‘We shall continue to fight the disease that took him away. At present we cannot cure it: but I have lived long enough to see many diseases that appeared irremediable 10 and 20 years ago come with the score of cure. We shall not forget [name of the patient] nor his malady’. (PR4.19968)

Norman Dott was no doubt a remarkable man, both for his talent as a surgeon and for his humanity and kindness. Happy Birthday Mr Dott!


sources

Rush, C., and Shaw, J. (1990) With Sharp Compassion, Aberdeen: Aberdeen University Press, p.176-216.

LHSA collection, LHB1/CC24/PR.2 and LHB1/CC22/CC4 

Friday 19 August 2016

Exhibiting archives

This week’s blog is a shameless plug for a couple of fabulous exhibitions in Edinburgh University Main Library…

We have not one, but two, displays over the next few months that concentrate on the display of archive collections. It can be difficult to create a visual feast of an exhibition that is based around archival material – so much of it is loose sheet material that there’s often a lot of beige and printed text! But with some high quality collections and lashings of imaginative design we have two stunning exhibitions that showcase collections held here in the Centre for Research Collections.

The first is ‘Godfrey Thomson: the man who tested Scotland’s IQ’, the University’s Fringe Festival exhibition for 2016. Open from Monday – Saturday, 10am – 5pm (free entry) in the ground floor Exhibition Gallery, this display highlights the life and career of a remarkable man; Thomson was the largest-scale producer of IQ tests in Europe, testing the intelligence of every 11-year-old in Scotland in 1932 and 1947. Professor Ian Deary and his team have gone on to draw on that data to look at how childhood intelligence relates to intelligence and health in old age. Although no LHSA material is in the exhibition, we have been able to contribute to Professor Deary’s research by providing birth weight information for those participants in his Lothian Birth Cohort. For more information about this research please see http://bit.ly/2b5UaXP, and http://bit.ly/2b5ugpQ for the details of the exhibition.
Inside 'Godfrey Thomson: the man who tested Scotland's IQ'
The second exhibition is in the Binks Display Wall on the 6th floor of the Main Library. ‘Enhance, Access and Understand: the University of Edinburgh and the Wellcome Trust’ looks at seven of the Centre for Research Collections’ recent projects funded by the Wellcome’s Research Resources programme. The display shows the diverse nature of the collections whilst also highlighting the specialist archive and conservation skills required to realise the projects. Here you can view examples from our UNESCO-recognised HIV/AIDS collections, and see how storage methods have been devised to meet their long-term preservation needs. Our work to catalogue case notes also features along with the cataloguing of Godfrey Thomson’s own archive, which can been seen in the flesh in the exhibition five floors down! Like the Exhibition Gallery display, it is free but opening times are slightly different: Monday – Friday 9am – 5pm until 31 October.


Two views of the Binks' Display Wall exhibition - featuring Norman Dott on the steps and an early method of treating respiratory disease: a Nelson's Inhaler.
We are running a series of talks alongside ‘Enhance, Access and Understand’. Tickets are free but bookable via Eventbrite. Information on all the talks on offer can be found here: http://www.ed.ac.uk/information-services/library-museum-gallery/crc/events-exhibitions/events
Hope to see you there!

Friday 12 August 2016

War hospital women

This week, Louise concludes her series of blogs on the role of women in medicine in our region during the First World War. Her last blog looked at women serving on foreign battlefields, but she has discovered that a posting in one of Edinburgh’s military hospitals brought experiences mentally (and sometimes physically!) far from home too:

For the nursing staff of Scottish military hospitals during the First World War, there were many rude awakenings. For professional, hospital-trained nurses, the influx of casualties must have been a shock, along with the injuries that came as a result of mechanised warfare on a mass scale. Some hospitals specialised in the horrific injuries that trench warfare brought, such as Edenhall Hospital for Limbless Sailors and Soldiers (sited at Pinkieburn, Musselburgh from early 1918). Edenhall developed and made mobility aids onsite - you can see some at the front of this photo:


Patients and staff at Edenhall, c. 1917,(Acc 12/054)
For volunteer nurses drafted in for wartime needs (Voluntary Aid Detachment nurses trained by the Red Cross in basic skills – VADs), the comparisons with life before the war must have been even more stark. Not only did most women enter the working world for the first time and lived away from the family home, but they were also exposed to the male-dominated life of the ward, with bodies, blood and bone becoming commonplace sights for them.

But serving in a Scottish military hospital did not necessarily mean seeing out the war on the home front. Having gained experience in caring for soldiers at home, nurses, doctors and orderlies from hospitals around Edinburgh were called to serve abroad. For staff at the 2nd General Hospital, Craigleith, this sometimes meant serving in the Mediterranean Expeditionary Force in North Africa. Here are Territorial Force Nursing Service (TFNS) nurses and Royal Army Medical Corps members taking time away from duty at the pyramids in Egypt in a photograph sent back to be published in the hospital magazine, the Craigleith Hospital Chronicle:

Craigleith staff in Egypt, 1916 (GD1/82/12)
TFNS nurses were professionally training nursing staff, who volunteered to care for the wartime territorial forces (that is, those who volunteered to fight rather than professional soldiers). I think that that these particular nurses are TFNS nurses (rather than VADs) on account of their uniforms. There’s more on military nursing uniforms on the excellent Scarlet Finders site, here

Camels in Egypt were not just for fun. In 1916, a Scottish medic serving in the military hospitals sent the Craigleith Hospital Chronicle this article:

Article heading, 1917 (GD28/6)
The author mentions the very important transport roles that camels played in military life, and the need for regular rest from the punishing life of a working animal:

“They are being used in thousands as transport to carry food, ammunition etc…Within five minutes walk of my home… there is an enormous rest camp where they get treatment, food and rest…. In the Camp there is a dipping tank like those used in Scotland for dipping sheep…”

The end of the war did not bring respite for the hardworking nurses of the 2nd General Hospital, Craigleith, who were to have one last adventure – sailing from Leith to Danzig to bring back sick and wounded prisoners of war. Again from the Craigleith Hospital Chronicle, we learn that a nursing sister and three staff nurses spent a total of eight weeks on board their ship, the Western Australia, during December 1918 and January 1919:

Article illustration and caption, 1919 (GD28/6)
They witnessed the relief at war’s end, and saw the results of its horrific effects, as this quotation shows – which must have been quite a shock for these middle-class women, even if they were hardened by their military hospital experiences:

“Next day we see Russian prisoners being transferred from barges to ships with Waffenstillstand and Armistice painted on them. We see the Russians scraping the decks and winches with their knives for fat, and eating it.”  Staff-Nurse E D Robertson


The article also mentions events that would shape the world to come. For example, Nurse Robertson reports that different attempts to evacuate British former prisoners of war from Germany were hampered by the start of the 1918 November Revolution (which would eventually lead to the Weimar Republic).

One of the strongest things that you see in the Craigleith Hospital Chronicle is how life must have changed for women as a result of their wartime experiences. We often think of auxiliaries in terms of the Second World War, but this poem shows that women played a crucial support role from 1914 to 1918 for the Army (WAACs), Navy (Wrens) and Women’s Royal Air Force (Penguins  - because they did not fly!):

Craigleith Hospital Chronicle poem, 1918 (GD28/6)
And this advertisement for insurance for the ‘income earning woman’ simply would not have existed before the war:

Craigleith Hospital Chronicle advertisement, 1918 (GD28/6)
The lighthearted humour in the Chronicle also reveals more than it may have originally intended. Times were changing for women just as they were coming into the workplace in great numbers out of the necessity of warfare. This cartoon, although undoubtedly in poor taste, hints at this change, as well as displaying not a little bit of apprehension at a world that looked to be turning upside down. It reads:

"PTE. MURPHY (who is to be kept without food for 24 hours), as Nurse passes him: 'Shure, Nurse, dear, I hope they don't think I'm a Suffragette.' "

Craigleith Hospital Chronicle cartoon, 1918 (GD28/6)ption

Friday 5 August 2016

TB, the BCG, and the RVD

This week, our Project Cataloguing Archivist Rebecca looks at the development of the BCG vaccination and its introduction to Edinburgh:

I’m sure many of you will have the distinctive scar on your arm from the BCG [Bacille Calmette-Guérin] vaccination, which protects against tuberculosis [TB]. The vaccination works by injecting one with a weakened form of tuberculosis, so that the body is able to recognise and defend against the bacteria if one comes in contact with the disease.

A BCG poster on display as part of a public health exhibition, c. 1952. [P/PL16]
It is named for the men who developed it, Albert Calmette and Camille Guérin; they began their work in Lille in 1900, and worked throughout the German occupation of the city during World War I to create a weakened form of tuberculosis bacteria which wouldn’t cause infection when injected into animals. In 1921 the vaccine was ready for testing on humans, and was first administered orally to an infant whose mother had died from tuberculosis; by 1924, 664 infants had been vaccinated with BCG, and in the next four years 114,000 infants were vaccinated without serious complications. The vaccine was taken up in various European countries, but British doctors remained sceptical of its effectiveness, and in the US there were some concerns over the safety of the vaccine.

These concerns came to a head with the Lübeck disaster in 1930, in which a scheme to vaccinate 250 newborn infants led to 73 deaths and 135 infections of tuberculosis after a contaminated vaccine was used; though the BCG itself was not the cause of the disaster, confidence in it dropped considerably. However, when tuberculosis became a major public health concern in the aftermath of World War II, which led to renewed vigour in attempts to find a cure. Trials of BCG carried out in the UK at this time showed that the vaccine was highly effective when given to children who had not previously been infected with tuberculosis, leading to its adoption in this country.
Case notes from the Royal Victoria Dispensary, 1950, [LHB41/CC/2/PR2] , showing: (L-R)
A record that the patient was vaccinated and subsequent positive Mantoux tests, a form consenting to vaccination, and a negative and a positive Mantoux test result.

From around 1950, the Royal Victoria Dispensary [RVD] gave BCG vaccinations to children and young adults who were in close contact with a tuberculosis sufferers. A Mantoux test was given to all attendees of the clinic in order to determine if they had already been exposed to TB bacteria. If a young patient had a negative response to the Mantoux test, indicating that hadn’t been infected already, they would be given the vaccination in order to protect them against catching the disease in the future.

The 1949-1950 Annual Report of the Royal Victoria Tuberculosis Trust shows the optimism that the success of the vaccine brought to the community, proclaiming that “[t]he tuberculosis BCG vaccine has been accepted as being of value in stimulating immunity, and its increasing use among those approaching puberty who have not already come successfully through a tuberculous infection will prevent much of the morbidity and mortality of that period of life.” In this spirit, from the mid-1950s the UK introduced the routine vaccinations of school children, which continued until its replacement with a more targeted programme of vaccination in 2005.

A girl receives a BCG vaccination, 1953 [LHB16/38/21]
 
Sources:

LHB41/7/1 Annual Report, 1949-1950
LHB41/CC/2/PR2
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749764/
http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx
http://patient.info/doctor/bcg-vaccination