Senator Lister Hill: Statesman for Health and Patron of Medical Libraries, 1971
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senator lister hill states for health and patron of medical libraries martin m cummings m d i am pleased to participate in this important ceremony the dedication of a new medical library is a significant event in any setting it becomes an exciting event when it serves to honor an individual who has done more to support libraries than any other person since the time of andrew carnegie one must ask how does a distinguished attorney aid national political figure become interested in health and medicine clearly in the case of the man we honor here today senator lister hill the interest and inspiration were drawn from his father dr luther l hilll a distinguished alabama surgeon a perceptive son who admires his father can be influenced to respect his father s profession only if the parental examples of behavior a per formance meet the idealistic aspirations of the young this surely obtains in the hill family father son relationship in reviewing the autobiographical memoirs of lister hill prepared by dr harlan phillips and senator hill in 1967 it becomes clear that senator hill not only respected his father s surgical skills but also his dedication to continued self education after describing his father s formal education in new york philadelphia and paris senator hlll describe his father's oslerian love of medical literature and his sustains use of this literature throughout his career speaking of his father s postgraduate director national library of medicine to be presented at the dedication of the lister hlll library of the health sciences of the university of alabama in birmingham october 19 1971

Page  2 2 training senator hill said he subscribed to the british medical journal he subscribed to the london lancet publications like that those british publications and he read them as religiously as he did the publications here in the united states for that matter he used to get certain publications from germany he didn t read german but there was a very fine lady who was the wife of a doctor by the way her husband taught biology at the university of alabama dr john y graham he had been to school over in germany and his wife was a german she could speak and read german well so my father would turn these articles over to her mrs graham and she d translate them for my father he was trying to keep up trying to keep ahead of the game all the time see what i mean whereas dr hill was trying to keep ahead of the game physicians today do well to keep up with current advances in medical practice an active service oriented medical library can do much to assist in this effort discussing the role of the library in postgraduate work osler in 1909 wrote so far as the library is a factor the greater part of a man s postgraduate education must be at home in this country no man practices far from a county town in which there is a medical society or general hospital with a library attached a notebook for special points to look up or for certain books of reference will get him into the habit of frequenting it and he should become a subscriber as in this way mot only does the library widen its influence but finds means for its support the county library wherever situated should be the much esteemed consultant of the general practitioner

Page  3 today few practitioners are expected to be library subscribers instead because of the farsighted legislation sponsored by lister hill all of our nation s medical libraries provide free medical library services in the american tradition of the public library system envisioned by carnegie put another way senator hill took out a library subscription for 300000 physicians in our nation making it possible for them to have access to the world s medical information no person interested in medical libraries can come to alabama without recognizing that the administration faculty and staff of the university have built a fine collection dr volker dr hlll and mrs sara brown particularly deserve your respect and gratitude for their persistent efforts in behalf of this library this library also devoted its skills and energies to sharing its holdings with clients throughout the south in addition it has had an appreciation for the history of medicine having acquired many fine rare books amd manuscripts on behalf of the national library of medicine i am pleased to add several rare documents as a gift to the lister hill library they consist of memorials and other testimonials in support of an award for wllliam thomas green morton discoverer of anesthesia since they describe an effort to gain congressional recognition for medical research i will summarize a portion of this history w t g morton born in charlton massachusetts in 1819 after studying dentistry in baltimore began practicing in boston in 1842 in partnership with horace wells the partnership was dissolved amicably in the fall of 1843 morton stayed in boston and matriculated at the harvard medical school but was unable to complete the course for financial reasons working as a dentist and experimenting with a new type of

Page  4 artificial teeth morton became greatly concerned with the problem of pain he tried various techniques and substances being successful at last with ether in early october he performed several extractions with the patient under ether reports of this in the press attracted henry j bigelow a surgeon at the massachusetts general hospital leading to the famous demonstration on october 16 the success of the ether anesthesia was announced to the medical world in the boston epical afs surgical journal november 18 1846 morton applied for a patent but in fact it brought him no financial reward beginning in 1847 a group of surgeons at the massachusetts general hospital and later others around the country attempted to get so if kind of award to morton from congress their efforts continued until morton died in 1868 they were never successful chiefly owing to the activities of rival claimants especially charles t jackson who had a habit of claiming other people s discoveries and later the supporters of horace wells and crawford long whatever the merits of the contribution of jackson wells and long certainly the chief credit for the introduction of anesthesia into medicine belongs to morton during the long effort to gain congressional recognition for orton many valuable documents were published bearing on the history of the discovery of anesthesia and its early use this collection of morton testimonials consists of three of these documents one of them is unfortunately slightly soiled on the outside but otherwise they are as they issued from the printer for they came to nlm indirectly from william t g morton s own stock of these publications

Page  5 5 medical scholars everywhere respect your historical collection a splendid example of the use of the reynolds historical library is reflected in dr howard holley s book a continual remembrance based on letters from sir wllliam osler to his friend med milburn covering the period 1865-1919 mew insights of osler s early years and his peregrinations through canada the united states and great britain are derived from this informative and scholarly research i was amused by one line from osler s last letter to mllburn describing his fatal illness in 1919 i got influenza early in oct & have been in bed ever since have never had so long an attack cough of great intensity not much fever & i am not out of the woods yet in bed & with a trained nurse but i spect to pull thro his faith in bedside nurses may have been misplaced since unfortunately she did not pull him through i have another reason to be fond of the reynolds historical library it was here in 1964 that dr marjorie wilson and i met with senator hill to discuss the need for new legislation to assist our nation s medical libraries in that setting senator hill and we agreed to the fundamental concepts embedded in the medical library assistance act of 1965 the act contained provisions for 1 construction of library facilities 2 training of librarians 3 support of research and development in medical library science and related fields 4 support of studies in history of medicine 5 improvement and expansion of basic resources for medical libraries 6 the establishment of regional libraries 7 the support of biomedical publications and 8 the development of regional branches of the national library of medicine where indicated all of these programs have been

Page  6 6 implemented with the exception of the last one while we attempt to facilitate access to documents needed by health practitioners scientists and educators through improving the quality amd quantity of libraries and their services we are keenly aware of parallel developments that impact and in some degree impel our efforts the book is here to stay but information is being packaged in other ways as television enters the public schools as an instructional medium as our children use both audio and visual devices to increase their pleasure and improve their knowledge so can we foresee the day when these modalities will complement and supplement the texts we know so well the book remains because it is the cheapest most durable and transportable informatics device that can be used by anybody anywhere a properly indexed book can be scanned it can be put aside to be picked up again when the spirit moves a bookmark does the job of a computer in finding one s place in the program the book exists in great variety for many purposes no other information package is so flexible nevertheless audiovisual formats cannot be disregaded they too must be organized for access a typical library function as various medical schools compress their formal educational programs in different ways the use of different pedagogical technologies will grow few if any professors can admit that the student needs less knowledge of his particular field than time and experience have shown him to be essential to the embryo physician dentist or nurse the old lecture system therefore must be reinforced in some meaningful way in part because the former blocks of time are not available but also because the student is being recognized as having reached a substantial degree of maturity by the time he enters his professional education my friends across the country insist almost uniformly that the hopes aspirations and desires of their medical students

Page  7 7 are becoming important considerations in the formulation of curricula and their content youth apparently is having its day i would hope however that some attention would be paid to cur american educational heritage it is wholly within this twentieth century that medicine eliminated its diploma mills and elevated its trade schocl posture to a true educational experience melding the laboratory and the clinic into an effective organizational framework let us not forget the lessons of history lest we revert to rule of thumb and sheer empiricism at a time when biomedical science has endowed us with the ability to analyz and synthesize in preventing disease and treating the sick we must be sensitive to our errors of the past as a means of developing the future and this leads me to some remarks about medical history the teaching of history of medicine has been a subject of much discussion in recent years a conference sponsored jointly by the josiah macy foundation and the national library of medicine dealt with the basic question of faculty competence to teach this subject owsei tomkin distinguish medical historian indicates that any good teacher who knows the subject should do the teaching thus in medical schools the teaching may be done by surgeons internists basic scientists as well as historians since most medical schools do not have medical historians as members of the faculty student exposure to medical history is usually incomplete erratic or absent journal or medical history clubs serve this function in some schools their value often depends on one or several faculty members who guide the

Page  8 8 effort as it relates to their own personal interests such efforts should be encouraged since they tend to stimulate or enrich the humanistic qualities of mfdical students and young physicians serious consideration should be given to encouraging physicians in their green years to study history cf medicine as an avocation the rare physician who shows a deep interest in the subject should be offered an opportunity to get formal gaining in the field at a school like johns hopkins or yale where professional courses leading to degrees in medical history are offered in this way america will be assurer own personal interests sur own personal interests such efforts should be encouraged since they tend to stimulate or enrich the humanistic qualities of mfdical students and young physicians serious consideration should be given to encouraging physicians in their green years to study history cf medicine as an avocation the rare physician who shows a deep interest in the subject should be offered an opportunity to get formal gaining in the field at a school like johns hopkins or yale where professional courses leading to degrees in medical history are offered in this way america will be assurer own personal interests such efforts should be encouraged since they tend to stimulate or enrich the humanistic qualities of mfdical students and young physicians serious consideration should be given to encouraging physicians in their green years to study history cf medicine as an avocation the rare physician who shows a deep interest in the subject should be offered an opportunity to get formal gaining in the field at a school like johns hopkins or yale where professional courses leading to degrees in medical history are offered in this way america will be assured of having a continuous supply of medical historians however scholarship in medicine can be developed outside the field of medical history a comprehensive clinical review or sophisticated research report also requires historical perspective as the materials and methods section of a scientific paper requires careful amd accurate description so should the introduction to the report reflect a thorough review and analysis of the literature pertinent to the subject no physician or scientist should become so involved in his immediate technical achievements that he loses contact with the knowledge that preceded his work because few can really contribute to science without an understanding of prior work which formed a basis for his present studies now let me turn your attention to the present the so called information explosion is not a new phenomenon the scientific literature has been doubling in volume every 15 years since the publication of the first scientific journal 200 years ago today there are approximately 50000 scientific or technical periodicals published annually these journals contain

Page  9 9 more than 2 million articles medicine alone produces 6000 substantive journals which contain over 300000 articles at nlm we analyze about 225000 of these articles and announce their existence through our monthly index medicus each day brings forth the birth of three new scientific journals while only one dies during this period the publications explosion is too and one half times greater than the population explosion while i visit with you today 1000 new medical papers are being published more than can be read by the average person in a month how then can a responsible physician or scientist be expected to keep up with the advances in medicine the answer is that no one can be expected to read everything that is published he must be discriminating am highly selective using carefully produced current awareness and indexing services he can more easily choose those articles which are relevant or pertinent to his interests a good librarian can be of great assistance to the reader by matching the literature to a person s profile of interests this is what we try to do with recurring bibliographies and with computer generated searches tailor made to the individual s needs the number of books and monographs published are said to double every five years not only does this pose serious problems for libraries which must acquire catalog and store them it also presents the reader with am impossible task a report by the committee on scientific and technical communication of the national academy of sciences points out that in the field of science alone a man reading 200 300 words a minute would take 50 years to read a single year s output even if he spent 24 hours a day 7 days a week reading here again the answer comes from selection express bock

Page  10 catalogs and book reviews which characterize the content of books give the potential reader some guide and insight into the substance of the publication before it is acouired again a good librarian can be of great assistance to the reader in predetermining the relevance of book materials before the the task of reading it is undertaken your national library of medicine using its computer system helps readers and librarians by generating a current catalog which assists in this process it announces in abbreviated catalog format the titles and contents of some 15000 contemporary books and monographs published in the field of medicine alone finally i close with another reminder that information comes in modes other than the printed work personal communication meetings and conferences audiovisual productions all lead to information transfer do not judge the value of lectures and speechs on the basis of my imperfect example today unfortunately man can absorb and retain only a limited amount of information some are blessed with a better capacity for this than others all men however can learn the techniques of finding information and thanks to senator hill we may all freely have access to medical information in our libraries here in birmingham you can all profit from the investment made by your state in this new important facility look around and be exhilarated by the beauty and dignity of a library which reflects the spirit and contributions of the person for whom it is named particularly i am pleased that he is here to see what his inspiration has wrought

Page  11 1 phillips harlan sector hill autobiographical memoirs derived from audio tape interviews national library of medicine 1967 2 osler william the medical library in post graduate work brit med j 2 925-928 1909 3 holley h l a continual remembrance charles c thomas springfield ill 1968 p 115 4 blake j b education in the history of medicine hafner publishing co ny 1968 pp 53 84 5 national academy of sciences scientific and technical communication a pressing problem and recommendations for its solution a report by the committee on scientific aid technical communication washington dc 1969