This is a guest post by Dr. Michelle-Linh (Michelle) Nguyen, a primary care doctor and researcher at UCSF and the Zuckerberg San Francisco General Hospital.
As social distancing rules and regulations begin to relax, many of us are feeling the strain of prolonged social isolation and re-learning how to reach out to others.
On April 29th, 2021, 48 San Francisco and UCSF community members gathered virtually during the lunch hour on Zoom for a series of poetry readings and discussion centered around the human experience of medicine. Farah Hamade, the inaugural UCSF Library Artist-in-Residence, took visual notes and created an art piece that represents the event and experience (featured below).
Three poets—Kathleen McClung, Sharon Pretti, and Peggy Tahir—were selected through a submissions process from the San Francisco community to read their work. Sharon Pretti read a series of poems written during and after her brother’s pancreatic cancer diagnosis, treatment, and eventual death. Kathleen McClung read a sequence of sonnets inspired by her partner and her experiences navigating his treatment and surgery for a pituitary mass.
Peggy Tahir read a series of poems written for each radiation treatment she underwent for breast cancer. The readings were followed by a 10-second pause to create space for reflection and a rich discussion.
The introduction of the event and poetry readings were recorded with the poets’ permission. The recording was turned off for the discussion and closing to create a more comfortable, intimate space. After the event, the poetry reading recording, Farah Hamade’s art piece and a poem by Michelle-Linh (Michelle) Nguyen was shared with event registrants and the public.
The conference was convened to celebrate a decade of digitizing and making available medical history resources. Keynote speaker Dr. Jaipreet Virdi, Assistant Professor for the Department of History at the University of Delaware, presented her work on Digitized Disability Histories. She discussed disability identity as represented through material objects of disability, and examined how disability history is separate from medical history.
The program also included fascinating talks from nine other speakers, ranging from the rhetoric used in early 20th century motherhood manuals to medicalize infant care and degrade traditional knowledge, to using convolutional neural networks (CNN) to identify and label objects in historical images in order to visualize thematic collections at scale, to studying the historical lessons from popular culture and medical discourse of face masks during the 1918-1919 Flu epidemic.
UCSF Archives & Special Collections is a contributing partner to the Medical Heritage Library. In 2015-2017 A&SC collaborated with four other medical libraries to digitize and make publicly accessible state medical journals, funded by a $275,000 National Endowment for the Humanities (NEH) grant. 97 journal titles were digitized (nearly every state medical journal in the U.S.) resulting in over 2.7 million full-text searchable pages.
The Industry Documents Library has contributed over 5,000 video recordings to the MHL, beginning in 2012. These videos are part of our Truth Tobacco Industry Documents collection and include recordings of cigarette commercials, marketing focus groups, internal corporate meetings and trainings, depositions of tobacco company employees, and congressional hearings. The recordings document the industry’s marketing and public relations strategies to cast doubt on the harms of smoking and to prevent or delay public health regulations.
Every October we celebrate Archives Month to reflect on the value of historical materials and to highlight UCSF Archives programs and services. This year we are marking the occasion in the midst of the era-defining triple pandemic of COVID-19, systemic racism, and police violence, not to mention momentous political upheaval.
Now as much as ever, it is critical to protect the records of the past and of the present. We are living through and making history; we must ensure that a diverse and inclusive record of this time is preserved for those in the future to access and understand.
Here are some ways you can get involved to celebrate Archives Month:
Get started collecting and caring for your records (emails, photos, blogs, social media, reports, websites, etc). Consider submitting your materials to the UCSF COVID-19 Pandemic Chronicles.
Join us on Wednesday October 7 for #AskAnArchivist Day! UCSF archivists will be standing by from 10am-2pm PDT on Twitter to answer your questions and chat about archives and UCSF history. Ask us anything at @ucsf_archives.
To explore recordings of our past Archives Talks on topics ranging from Black Women Physicians’ Careers, Elderhood, Documenting While Black, and the Myth of the Perfect Pregnancy, please visit our Archives Events and Exhibits page.
This week, we join the International Council on Archives and colleagues around the world in celebrating archives and their role in empowering knowledge societies. Against a pervasive backdrop of disinformation, manipulated facts, and extreme prejudice which has fostered such horrific pain and suffering in our world, we recognize the value of archives and all those who uphold truth, accountability, and justice.
Archives perform an essential function as keepers of the records of evidence of human activities and experience. They directly encourage the creation of knowledge, the affirmation of the histories and identities of individuals and communities, and the transparency and accountability of government and other entities of power. Archives are not dusty enclaves of archaic knowledge for the privileged; they are living repositories of information which should reflect our societies, our decisions, and our lived experience. To celebrate archives is to celebrate a record of human progress, and to celebrate our collective ability to scrutinize and call out disparities and injustices embedded in that progress.
The theme of this year’s International Archives Week is Empowering Knowledge Societies. The concept of a “knowledge society” emerged from work first attributed to the management theorist Peter Drucker in the 1960s, and by the 1990s was being defined and contrasted against the idea of an “information society” as the proliferation of technologies like the internet and World Wide Web increased the production and spread of data. A crucial difference is that an information society is one which simply creates and disseminates raw data, often relying on technological innovation; a knowledge society is one which can study and evaluate that data in context to create knowledge which informs action.
Beyond our validation and promotion of these principles, archives and libraries must design our workflows and services to actively enable and empower these pillars of knowledge societies. Here at UCSF Archives & Special Collections, we strive to empower knowledge societies by providing open access to our collections, to the greatest extent possible, to all users, regardless of location or affiliation. We practice collection development which is aware and inclusive of diverse cultures and communities in the history of the health sciences, and we work to amplify voices which have historically been silenced or marginalized. We preserve evidence of harmful activities in industries which influence public health to enable researchers, policymakers, and members of the public to thoroughly investigate these sources and determine the best course of action to protect the health of our communities and our environment.
In 2005 UNESCO published a World Report titled Towards Knowledge Societies to lay out the global benefits of building knowledge societies, and the challenges many countries face in reaching that goal. The report emphasizes that “knowledge has not only become one of the keys to economic development; it also contributes to human development and individual empowerment. In this sense, knowledge is a source of power because it creates a capacity for action.”
We continue to work towards empowering knowledge societies through archives, to enable the action that’s urgently needed to address the systemic inequalities, racism, violence and injustice threatening the lives of people of color and the future of our communities worldwide. We are committed to building this capacity in partnership with and in awareness of the histories and experiences of all people, in respect and solidarity.
This is a guest post by Aaron J. Jackson, M.A, Ph.D. Candidate, UCSF History of Health Sciences.
From time to time, events in the
present so closely resemble events from the past that the aphorism “history
repeats itself” seems feasible. This can be demonstrated by comparing the
current crisis of the novel coronavirus with the influenza pandemic of 1918-1919.
The similarities are compelling. Like the SARS-CoV-2 coronavirus, the variety
of H1N1 influenza that swept across the world in 1918 and 1919 produced a
significant shock. It spread like wildfire, was frustratingly resistant to
contemporary therapeutics, exhibited novel characteristics, and forced
governments to resort to what some considered to be heavy-handed public health
interventions. Bay Area residents in 1918 were required to wear masks and
practice social distancing, just as they are required to do so today. Such
historical similarities are not, however, proof that history repeats itself.
But they do provide interesting opportunities for comparison between the past
and the present—opportunities that hold the potential to make the past more relatable
by building connections through common circumstances. And perhaps, through that
understanding, an opportunity for hope to shine in dark times.
This post is not an exhaustive
study comparing 1918 and 2020. Rather, it focuses on responses to crises and
specifically the ways that communities innovatively addressed shortages of
personal protective equipment (PPE). So, of course, it will be about war,
pandemics, socks, and sheet protectors. Naturally.
When the United States declared
war on the Imperial Government of Germany in April 1917, the nation was
woefully unprepared for the conflict. The war represented an unprecedented
crisis—one that required the federal government to assume new powers in order
to coordinate the resources of the entire nation. President Woodrow Wilson’s
administration worked with Congress to institute a draft to raise an army,
enacted strict economic control measures to conserve and direct resources
towards the production of war materiel, and passed laws that infringed on civil
liberties, all in the name of the war effort. To ensure public support for
these moves, the government mounted a massive propaganda campaign that appealed
to a specific version of American patriotism, appealing to citizens’ sense of
Mustering an army of sufficient size presented significant challenges. The men not only had to be inducted into military service—either by volunteering or being drafted—they required hundreds of training camps, transportation to those camps, equipment to train with, uniforms to wear. Once at the camps, they required food, shelter, and medical support. Military training was and remains a dangerous business, but the most significant medical problem at the cantonments was disease.
As tens of thousands of American
recruits assembled at Army camps across the United States, they unwittingly
brought diseases with them, which found ample opportunity to spread in cramped
camp conditions. Most of these infections fell into the category of “common
respiratory unknown disease”—an unofficial designation among military recruits
who learned to add C.R.U.D. to the lexicon of military acronyms they learned.
The crud largely consisted of the common cold and other respiratory infections,
but cases of measles, mumps, and chicken pox were also common. Most cases of
the crud cleared up without need for treatment, but the prevalence of these
infections and the fact that new waves of infections would spring up with every
new trainload of recruits had the effect of masking a more dangerous threat.
Army physicians first identified more than 100 soldiers who had developed a
rather severe flu-like illness in March 1918. Within a week, the number of flu
cases at Fort Riley was over 500 and climbing. The H1N1 virus that caused the
influenza pandemic of 1918-1919 had arrived, but the nation was focused on the
war. And as American troops began arriving in France and moving into the front
lines—many of them no doubt bringing the virus with them—medical personnel
tasked with supporting the war effort shifted their focus from induction
screening and camp illnesses to other health concerns.
The First World War introduced a bevy of new ways to mangle and maim human bodies. From high-velocity rifle rounds and machine guns to high-explosive artillery shells, flamethrowers, hand grenades, aerial bombardment, and chemical weapons, the U.S. Army Medical Corps understood that the hospital system it established in France had to be prepared first and foremost for trauma care, which posed significant challenges. Not only did modern weapons cause extensive damage, the risks of sepsis and gangrene in an era before the discovery of antibiotics were high. Complicating this, European battlefields tended to stretch across agricultural land, teeming with bacteria after years of fertilization. Soldiers wounded on the front lines thus ran an extremely high risk of bacterial infection. To address this, the Medical Corps and its affiliates prioritized training Army health care workers in antiseptic wound care.
The experiences of the personnel of Base Hospital No. 30 are instructive in this regard. Base Hospital Thirty was the military hospital unit assembled from physicians, surgeons, and nurses associated with the University of California’s School of Medicine—the precursor to UCSF. Organized with the help of the American Red Cross Society shortly after Congress declared war, the unit spent more than a year training for the anticipated challenges of running a hospital for wounded soldiers in France. The unit’s nurses received orders to depart San Francisco on December 26, 1917 and reported to Army cantonment camps along the East Coast to help care for soldiers who had fallen ill with the crud, gaining invaluable experience in nursing soldiers and recognizing disease presentation. The unit’s surgeons practiced the ancient technique of wound debridement—removing foreign objects and cutting away dead and dying flesh to produce a clean wound—and attended clinical instruction that prepared them for the types of injuries they would face. And the unit’s corpsmen trained in the production and use of the Carrell-Dakin solution, a novel antiseptic more effective than carbolic acid and iodine but also a solution that required careful training and preparation. Thanks to training like this, the base hospital system was able to treat more than 300,000 sick and wounded soldiers with remarkably low mortality rates compared to previous wars.
Indeed, the medical apparatus and personnel organized to support the American Expeditionary Forces were well prepared for the anticipated hazards of the war. But in one of the remarkable parallels to the current coronavirus crisis, their job was perhaps made more difficult by the failure of American logistics in providing adequate personal protective equipment. But the shortage in 1918 was not one of N95 masks; rather, it was a matter of needing socks.
Today, the Occupational Safety
and Health Administration defines PPE as “equipment worn to minimize exposure
to hazards that cause serious workplace injuries and illnesses.”[i]
Under this definition, and in the context of soldiering, a good pair of socks
certainly applies. Trench warfare was a dirty business. It also tended to be
cold and wet—the perfect climate for a condition known today as “trench foot.”
Afflicted soldiers’ feet would go numb, swell, develop sore and infections, and
in extreme cases become gangrenous, possibly requiring amputation. Obviously,
this ran the risk of keeping soldiers from the front lines and thus undermining
the war effort. But ensuring a plentiful supply of clean dry socks somehow
slipped through the cracks of the Army’s logistical efforts to prepare for the
war. Fortunately, the American Red Cross and thousands of civilian volunteers
found ways to meet the challenge.
Beginning in 1917, the Red Cross put out calls for knitted garments, especially socks. The organization distributed officially-endorsed knitting patterns and free wool to anyone willing to “knit your bit.” The Priscilla War Work Book contains roughly a dozen such patterns ranging from socks to coats and winter hats.[ii] But the demand was greatest for socks. Across the country, knitters worked individually at home and collectively in social groups to try to keep up with the demand. Those who could not knit were urged to purchase or donate wool for the cause. Some organizations turned to mechanical solutions. The Seattle Red Cross utilized a knitting machine to produce long wool tubes that could be cut into 27-inch lengths, requiring only the toes to be stitched by hand.[iii] In this way, those behind the front lines were able to support the war effort by providing the PPE the soldiers needed to keep themselves in fighting shape.
Celebrating the end
of the First World War in San Francisco, November 11, 1918. Image from The San Francisco Chronicle files.
The knitting campaign continued
until the war ended with the declaration of the armistice on November 11, 1918.
By then, the nation was in the midst of the first wave of the influenza
pandemic. On October 9, 1918, San Francisco’s hospitals reported 169 influenza
cases. A week later, there were more than 2,000 and the city’s Board of Health
issued recommendations for social distancing.[iv]
With so many health care professionals supporting the war effort, the Bay
Area’s medical infrastructure was stretched to the limit and cities put out
calls for volunteers. Hospital space soon became a valuable commodity and many
facilities, including the Oakland Municipal Auditorium, were converted into
temporary hospitals, and public health officials began recommending the use of
face masks, which they later made mandatory.[v]
But it is important to remember that these were local efforts to respond to the
pandemic. The federal government, which had mustered the resources of the
entire nation to fight the war in Europe, was unwilling to do the same to
combat the pandemic at home, leaving it up to local authorities, medical
institutions, and volunteer organizations to make do as best they could.
Unfortunately, we find ourselves
in a similar situation today. As the novel coronavirus took on pandemic
proportions, stores of PPE for frontline healthcare workers reached critical
levels. Before the pandemic, China produced approximately half the world’s
supply of medical masks. As the infection spread in China, their exports
stopped, and the resulting shortage spurred competition between institutions
and governments to secure PPE, which only exacerbated the situation.
Thankfully, a multidisciplinary team at UCSF found a way to be a part of the
solution, echoing the efforts of American knitters from over a century ago.
Noting the need for face shields, experts at UCSF specializing in biochemistry, engineering, logistics, medical workplace safety, and 3D model design came together in March 2020 to develop something that could help address the PPE shortage. By April, the team completed designs for three different models of 3D-printable face shield frames that, when combined with rubber bands and transparent document protectors, serve as functional and reusable face shields. They then collected seventeen 3D printers from across the university and turned the UCSF Makers Lab in the Kalmanovitz Library into an ad hoc face shield factory that can produce more than 300 shields each day—enough to supply UCSF’s front-line health care workers and then some.[vi] Extra shields are distributed to Bay Area hospitals. Moreover, like the Red Cross with the distribution of the Priscilla War Work Book, the UCSF team is sharing their plans in an open source repository so that others can emulate their efforts.[vii] This allows those with access to 3D printers and a few dollars’ worth of office supplies to contribute to the ongoing PPE shortage by producing face shields that have been designed, tested, and vetted by experts at one of the nation’s leading medical institutions.
Certainly, there are remarkable
similarities to be drawn between the modern crisis and those in the past. Once
again, the government was unprepared for a crisis despite advanced warning.
Once again, people are working in the front lines to save others despite
inadequate supplies. And once again, like the First World War and the influenza
pandemic of 1918-1919, the coronavirus pandemic is a devastating event likely
to be measured in the tally of lives lost. In the face of such grim statistics,
it is easy to fall into cynicism and say that history is repeating.
In 1905, philosopher George
Santayana explored the notion of progress—the idea that things move toward
improvement—and stated that “those who cannot remember the past are condemned
to repeat it.”[viii]
This is likely the origin of the aphorism “history repeats itself.” But Santaya
was not making a hopeless argument; rather, he noted that if progress is to be achieved,
it will be because humans not only record the past, they engage with it, learn
from it, and seek to understand it. And how that is achieved depends on the
ability to draw relatable connections with the past that emphasize human
agency. In 1918, knitters took up their needles. Today, a team of scientists,
engineers, and others figured out how to make face shields using 3D printers
and office supplies. These may seem like small contributions in the grand
scheme of things, but they are important examples of positive human agency in
the face of crisis.
Schappel Barsaloux and the American National Red Cross, The Priscilla War
Work Book: Including Directions for Knitted Garments and Comfort Kits from the
American Red Cross, and Knitted Garments for the Boy Scout. Boston, Mass.:
The Priscilla Publishing Company, 1917. Available at the HathiTrust Digital
By Erin Hurley, User Services & Accessioning Archivist
Although, in 2020, advice like “wash your hands” and “cover
your mouth when you cough” seem fairly obvious and common sense, there was a
time when this was not the case. That time was March 1855, when the situation
in British hospitals outside of Constantinople (now Istanbul, Turkey) during
the Crimean War had become so dire that Florence Nightingale and 40 other women
acting as trained volunteer nurses were finally allowed access to patients
(they had previously been denied access because of their gender). Hospitals
were overcrowded and extremely unsanitary conditions encouraged the spread of
infectious diseases like cholera, typhoid, typhus and dysentery, which Nightingale
recognized immediately. She implemented basic cleanliness measures, such as
baths for patients, clean facilities, and fresh linens, and advocated for an
approach that addressed the psychological and emotional, as well as the
physical, needs of patients. Her improvements brought a dramatic decline in the
mortality rate at these hospitals, which had previously been as high as 40%.
While Nightingale is well known as one of the world’s first nurses, she is less well known for her strikingly lovely data visualizations (including pie charts and a rose-shaped design called the “coxcomb”), which she used to highlight the number of deaths from diseases, in addition to deaths from wounds or injury, during the Crimean War. Nightingale, a mathematician and statistician, recognized the importance of eye-catching visuals in communicating the impact of her innovations.
The archives team is wishing you joy and peace during the holidays and throughout the New Year.
As 2019 comes to an end, we wanted to express our gratitude for the ongoing support of our colleagues, donors, interns, and collaborators.
The Archives & Special Collections will be closed from Saturday, December 21, 2019 through Wednesday, January 1st, 2020. We will reopen on Thursday, January 2nd.
If you submit a question through Ask an Archivist or make a reservation for the reading room during that time, please note that we will begin reviewing reference questions and reading room bookings when we re-open on Thursday, January 2, 2020.
Memory Lives On: Documenting the HIV/AIDS Epidemic is an interdisciplinary symposium exploring and reflecting on topics related to archives and the practice of documenting the stories of HIV/AIDS.
The task of documenting the history of HIV/AIDS and thinking about the present and future of the epidemic is daunting. The enormity and complexity of the stories and perspectives on the disease, which has affected so many millions of patients and families around the world, present significant challenges that demand continual reexamination. Questions of “what do we collect and from where” and “whose stories do we know best.” The ways in which we handle documentary evidence and produce knowledge from that evidence has profound effects on a huge range of social, economic and health outcomes. In examining and reflecting on our knowledge of the history of the HIV/AIDS Epidemic and its future, we hope to improve our understanding of the true effects of the disease, and what it can teach us about future epidemics.
The program committee invites submissions for presentations addressing the HIV/AIDS epidemic from the wide-ranging perspectives of historians, archivists and librarians, artists, journalists, activists and community groups, scientific researchers, health care providers, and people living with HIV. We invite proposals from individuals with diverse experience and expertise on the HIV/AIDS epidemic in scholarship, research and advocacy. Proposals will be considered in a variety of forms including paper presentations, panel discussions and posters.
The Symposium will take place in Byers Auditorium in Genentech Hall at the UCSF Mission Bay Campus in San Francisco, October 4th and 5th 2019. The program will be an afternoon session and evening reception the first day, followed by a full day of presentations the second.
The Program Committee has identified the following themes to consider when developing your proposal, though we encourage creativity and experimentation in exploring themes, partnerships, and narrative ideas.
Documenting the epidemic: Gaps, silences and unheard voices
Creating an interdisciplinary narrative of an epidemic
Silent no more: Community, caretaker and patient stories
The San Francisco Bay Area’s Response to the AIDS Epidemic
Biomedical story: From mystery disease to cure
From local to global: Learning from AIDS to address future epidemics
The Program Committee welcomes proposals for individual papers, panel discussion and posters. Individual papers with a similar focus will be assembled into a single session by the program committee. Usually 3-4 papers are included in a session. To allow adequate time for questions and discussion, panels should be limited to four participants in addition to a chair/facilitator. Please include the following in your complete proposal
Session title if submitting a full panel proposal (of no more than 20 words)
Session abstract if submitting a full panel proposal (up to 500 words)
Short session abstract for the program if submitting a full panel proposal (up to 50 words)
Paper or poster or presentation titles (if any), and names of corresponding presenters
Biographical paragraph for each presenter
E-mail address for each participant
Affiliation, city, state, and country for each participant
Social media handles or web addresses for each participant (optional)
Special accommodation needs
The deadline for submissions is June 3. We will notify presenters if their proposal has been accepted by July 22.
Memory Lives On Program Committee
Victoria Harden, Ph.D., Director (retired) of the Office of NIH History
Monica Green, Ph.D., Professor of History, Arizona State University
Richard McKay, DPhil, Director of Studies for HPS at Magdalene College
Barbara A. Koenig, Professor of Medical Anthropology & Bioethics in the Department of Social & Behavioral Sciences, Institute for Health & Aging and Head of UCSF Bioethics Program
Jay Levy, MD, Professor UCSF School of Medicine
Eric Jost, Digital Marketing Manager, SF AIDS Foundation
Jon Cohen, Staff writer for Science Magazine
Mark Harrington, Executive Director, Treatment Action Group
William Schupbach, Wellcome Library
Jason Baumann, Susan and Douglas Dillon Assistant Director for Collection Development and Coordinator of Humanities and LGBT Collections
Polina Ilieva, Head of Archives & Special Collections, UCSF Library
The archives team would like to express our gratitude to all our supporters, donors, users, collaborators, interns and colleagues for helping us grow our holdings, uncover, describe, and digitize previously hidden collections.
MONDAY DEC 10, 12 – 1:15 PM
5TH FLOOR, LANGE ROOM,
Join Associate Professor of History, Deirdre Cooper Owens as she explains how the institution of American slavery was directly linked to the creation of reproductive medicine in the U.S. She will provide context for how and why physicians denied black women their full humanity, yet valued them as “medical superbodies” highly suited for experimentation. Engaging with 19th-century ideas about so-called racial difference, Cooper Owens will shed light on the contemporary legacy of medical racism.
Go beyond the Archives Talk with a Master Class led by Associate Professor of History, Deirdre Cooper Owens. Space is limited, REGISTER HERE.
Deirdre Cooper Owens, Ph.D., Associate Professor of History at Queens College, CUNY in Queens, New York and an Organization of American Historians’ Distinguished Lecturer