Medical school

A homecoming

In archival parlance, provenance refers to the original source or creator of a collection of material. Provenance is fundamental to preserving context for records and is the principle that provides the authority we give to records as being original.

After establishing provenance, archivists seek to preserve the original order of the material. This is generally considered the same sequence the original creator stored the records. It preserves the context of the materials.

Then there are times when records come to the archives without any provenance and are out of sequence. When enough clues are available, the restoration of original order is the best possible solution.

Such is the case with two folders labeled “Wilson, Dr. L. B. Mayo Foundation Rochester Minn.” One dated “1921-1925,” the other “1926-“.

img0130.jpgFound among 1970s Medical School administrative records, the look of the folders, the dates of the material, and the content they contained all support the conclusion that they were not created by the dean’s office of the 1970s and were thus out of context and without an established provenance.

These folders primarily contain correspondence between Louis B. Wilson and Clarence Jackson, then head of anatomy at the University of Minnesota. The letters pertain to the transfer, release, and burial of corpses used for dissection between the University of Minnesota and Mayo.

It can be said that due to their intimate knowledge of an institution and changes in an organization over time that archivists figuratively know where all the bodies are buried. Yet, these two folders quite literally tell the story of where they are buried. The “they” being unclaimed bodies available for anatomical study and managed by the Medical School according to a 1913 state law.

A review of existing collections in the archives proved to be fruitful. A two box set of records transferred from the Department of Anatomy to the archives in 1951 contained identical folders, similar correspondence between Dr. Jackson & other individuals regarding the management of bodies for anatomical study, and a noticeable absence in the alphabetical order of correspondence files for an entry under “Wilson.”

At some point between 1926 and 1951 someone removed these two folders from the Dept. of Anatomy, yet the folders managed to remain paired together as they moved from office to office, hand to hand over the next 60 to 80 years until finally sent to the archives. The transfer of these seemingly miscellaneous materials to the archives was the key step in restoring their provenance and establishing their original order.


Dr. John W. LaBree

img0118.jpgDr. John W. LaBree, former Dean of the School of Medicine at Duluth and Assistant Vice President for Health Sciences, passed away on August 1, 2009.

His published obituaries (U of M; Startribune) have documented his outstanding achievements including his pioneering work in heart catheterization and his 70-plus-year relationship with the University of Minnesota’s health sciences from med student to assistant vice president.

Yet, archives can help us look back and see Dr. LaBree’s early career before the lifetime achievements and accolades.

The photo above is from 1950 while serving as an Instructor of Medicine at the University, a year before founding the St Louis Park Medical Clinic.

The notice below is from the February 15, 1946 Board of Regents minutes announcing his appointment as a Medical Fellow.

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Chicken or the egg?

Which came first: the original students admitted to the Medical School or the first graduates?

If you said graduates then you must be paying attention.

In the past I’ve discussed how the original requirements for admission to the Medical School (then known as the Department of Medicine) where formulated in April of 1888 with the first class entering in October of that same year. Prior to that, the College of Medicine consisted of faculty members that served as an examination body that recommended candidates to the Board of Regents to receive a Bachelor of Medicine or M.D. It did not provide instruction, rather it assessed all candidates on their scientific and professional skills. The first graduates earned their degrees in 1884. Four years before the first entering class. Those graduates were James Simpson and Hugo Speier.

The following is a partial list of examination questions they faced in 1884.

Anatomy

  • Give Chemical composition and microscopic structure of bone.
  • Give boundaries of the Fourth Ventricle.

Physiology

  • Fats: Variations and use in the economy.
  • Protein compounds: Characteristics and ultimate destination.

Medical Chemistry

  • Describe the symptoms of poisoning by oxalic acid. (a) Mention the antidote or antidotes for oxalic acid, with an explanation of their actions. (b) How is oxalic acid liable to be taken by mistake?

Pathology

  • What condition of the brain would you expect to find in a case of death from acute alcoholic poisoning?
  • What is Cancer? Describe its varieties.

Sanitary Science

  • What do you understand by Preventive Medicine as distinct from public or private hygiene? Give an illustration.
  • Name the dangers to health most likely to occur in the house of a farmer or in a private house in towns or cities. State how you would search for them and how prevent or remedy them.

Surgery

  • How should a punctured fracture of the skull be treated?
  • For what injuries and diseases is amputation generally performed?

Practice of Medicine

  • Is there a distinction between functional and structural diseases? If so, give a definition of each kind and illustrate by example.
  • What is Meningitis and what are its results?

Diseases of Women & Children

  • Give anatomy of the Uterus.
  • Give differential diagnosis of scarlitina and measles.

Read the faculty minutes for the College of Medicine from 1883-1886 and see the full set of examination questions (pages 21-28) below.

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1926 or 2009?

On July 27, 1926 then University of Minnesota President Lotus D. Coffman wrote a letter to Dr. H. M. Johnson, Chairman of the Committee of the Minnesota State Medical Association outlining the University’s business plan to put into practice the employment of full time clinical instructors and the use of the hospital facilities by private & per diem patients.

Many of the concepts in Coffman’s letter are echoed in today’s discussions regarding the clinical enterprise and partnerships. To see the parallels one has to look no further than last month’s presentation to the Board of Regents “Moving the Clinical Enterprise from Partnership to Integration: Conceptual Framework.”

Although the style of language for the most part reveals their age, read the following excerpts from the above two mentioned documents and see if you can guess their date of origin: 1926 or 2009.

  1. Enhanced ability to recruit and retain faculty and compensate them at a competitive market rate. 1926 or 2009?
  2. The problem of securing and keeping a staff of talented and enthusiastic teachers is one of the most difficult and continuous tasks that confronts any university. 1926 or 2009?
  3. Greater access to a larger population for participation in clinical research and to support the education of the next generation of health professionals. 1926 or 2009?
  4. The University here faces the practical necessity of providing enough hospital beds to insure those types of cases and diseases, and in sufficient numbers, that may be necessary for the education and training of those proposing to enter the professions of nursing and medicine. This is a great educational responsibility which the University cannot fail to discharge. 1926 or 2009?
  5. Enable the health professions of the AHC to achieve relevance, leadership and excellence into the 21st century. 1926 or 2009?
  6. Ambitious clinical and laboratory teachers will not associate themselves, even for high salaries, with an institution which cannot offer good opportunities for their continuing growth and intellectual development. 1926 or 2009?

Feel free to leave your answers in the comments and read the full letter from President Coffman as well as the details about the clinical framework at the University in 1926 below.

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No vestige of a beginning, no prospect of an end

A diagram of the geological time scale available from the US Geologic Survey (public domain)The teaching of geology often starts with an introduction to the geologic time scale as a means to acquaint students with the concept of deep time and how to better comprehend eons, eras & epochs.

Although littered with catastrophic events such as meteorite impacts, volcanic eruptions, and earthquakes, the surface of the earth and the life forms it has supported have been most profoundly changed by the incremental affects of water, plate tectonics, and photosynthesis over the course of 4.5 billion years.

So, do archives have a deep time?

Occasionally, the events that bring records to the archives are cataclysmic: the death of an individual, the closing of an organization, or even a natural disaster. These same catastrophes all too frequently tilt toward the utter destruction of the materials and remove them entirely from the record.

But more commonly, records trickle in like water, move slowly from one place to another, and even proliferate through technological photogenic processes such as the photocopier and scanner.

These deep time thoughts, so to speak, came to me last week as I looked over a recently acquired collection of correspondence. The letters are to and from Hal Downey (1877-1959), a world-renowned hematologist who spent the majority of his life studying, teaching, and researching at the University of Minnesota.

The collection is largely exchanges between Downey and his colleagues in the U.S. and Europe before World War I through the late 1950s. Most notable are a series of letters related to Dr. A. Maximov, a Russian hematologist looking to escape the restrictive conditions of early Soviet Russia. Downey eventually helped Maximov secure a position at the University of Chicago.

However, it was actually a pair of letters that set my thoughts in motion. The first was a letter from E. W. McDiarmid the University Librarian dated February 26, 1946 on the occasion of Downey’s retirement. In his letter McDiarmid requested that Downey consider turning over to the archives any material he will no longer need in his retirement. He specifically asked for letters, committee reports, and departmental correspondence that may be in his possession.

Downey responded that “it is not likely that I have anything of importance” and that he hoped to remain in his lab space for years to come. He would remember the archives if anything seemed of value.

Sixty-three years later, Hal Downey’s daughter and two granddaughters deposited his valuable correspondence in the archives. The material joined a small collection of Downey’s manuscripts that were donated by his wife Iva shortly after his death in 1959. It was a lifetime between McDiarmid’s request and the actual deposit. It was a fraction of the University’s history. It was a blip on the geologic time scale.

If we are students of the earth then we realize that none of us are permanent residents of this planet, nor are our institutions. Yet, to invoke Hutton, archives exist because we see “no vestige of a beginning, no prospect of an end.” So, we create, document, preserve, and then begin again.

Read the letters between McDiarmid and Downey below.

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Image Credit: A diagram of the geological time scale available from the US Geologic Survey. Source image available from the Wikimedia Commons.


An historical evening

April 26 marked the 121st anniversary of the Department of Medicine as established by the Board of Regents, which included the College of Medicine and Surgery and Dentistry. Although the original charter for the University of Minnesota listed a medical school as a component of the University, it was not formally opened until 1888.

I was once told that in the minds of most people, history begins the day before you were born. All other things that happen during the course of your life seem like current events because you experienced them one way or another.

It can be curious then to see how others celebrated their own lived history long before present day. The book below is one such example. It is a collection of essays documenting the history of medical education in Minnesota from the mid nineteenth century up until 1908. The first 20 years of the Medical School takes center stage and the essays are presented primarily by the individuals who formulated its organization.

The book concludes with a look forward and to three primary needs for medical education in Minnesota: the addition of hospital & laboratory space; better cooperation with state institutions; and ways to diffuse medical knowledge to physicians & the public.

Before reading the book, consider the fact that more than 85% of the history of the Medical School has taken place since this historical evening. How will your life’s experiences fit into someone else’s history?

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Riddle

What do a gunshot wound, wet film, and a charitable donation to a children’s hospital all have in common?

They all have direct ties to innovative thinking and research in the University of Minnesota’s Department of Radiology.

In 1896 the University paper Aerial described a procedure at the St Paul City Hospital that allowed for the detection of two bullets in a leg with the use of an x-ray machine. Dr. Jones of the Medical School performed the procedure just eleven months after Wilhelm Konrad Roentgen discovered the detection of electromagnetic radiation.

In the early 1930s, then division head Dr. Leo Rigler set up a wet film viewing area in order to allow for almost immediate interpretation of results especially for emergency cases. Until the advancement of film processing, this provided the best means for real time results.

By the late 1960s, Dr. Kurt Amplatz had already become well-known for his innovative work in cardiovascular radiology and specifically in angiography. His research in this area eventually lead him to design his Amplatzer® septal occluder, which allowed for the repair of congenital heart defects in children. The announcement last week of the $50 million dollar gift in Dr. Amplatz’s name to help build the new children’s hospital completes this thread running through the Dept. of Radiology.

To learn more about these people and their contributions read the 1967 essay “A Brief History of the Department of Radiology” by Stephen Kieffer, Eugene Gedgaudas, and Harold Peterson available below.

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The long view of islets

A recent article in the Star Tribune highlights current research at the University of Minnesota and the Mayo Clinic to find a cure for diabetes. Researchers are hoping to implant insulin producing islets from genetically modified pigs into humans with diabetes. The projected outcome would be an on-going production of insulin that would reverse the effects of diabetes on the body.

Experimentation with insulin as a cure for diabetes has been a primary focus for curing the disease since the early 1920s. Dr. Frederick Banting, a medical researcher at the University of Toronto, received the Nobel Prize in Medicine in 1923 for his research in isolating and producing insulin.

Yet, Dr. Banting always credited his eureka moment in understanding how to extract insulin from reading the article “The Relation of the Islets of Langerhans to Diabetes with Special Reference to Cases of Pancreatic Lithiasis” published in the November 1920 issue of the journal Surgery, Gynecology and Obstetrics. The article’s author was Dr. Moses Barron, a professor in the Department of Pathology at the University of Minnesota.

Dr. Barron’s article not only influenced Banting’s work and the 90-year trajectory of insulin management of diabetes, but it also influenced diabetes related pancreas transplantation research including the work of Drs. Richard Lillehei and William Kelley in the 1960s and 1970s, also at the University of Minnesota.

Read a 1934 letter from Dr. Banting to Dr. Barron where he gives credit where credit is due.

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Dr. N. L. Gault

Dr. N. L. Gault, or Neal to just about everyone he met, passed away on December 11. Dr. Gault was Dean Emeritus of the Medical School and Professor Emeritus of Medicine.

img0081.jpg(Pictured: Dr. Gault with his colleagues at Seoul National University, ca. 1960.)

Dr. Gault’s medical education began in Texas, brought him to Minnesota, and then took him on a world wide tour that included Korea, Okinawa, China, New Delhi, and then landed him for a short time as the Associate Dean for the University of Hawaii School of Medicine. In 1972, Dr. Gault returned to Minnesota and served as dean for the Medical School until 1984.

Dr. Gault served as dean during the expansion of the health sciences in the 1970s and early 1980s. It was once said that he lead a major expansion both physical and functional of the Medical School at a time when every basic resource was in full retreat. After completing his service as dean, Dr. Gault continued to be active at the University as a special staff to the Vice President for Health Sciences and as an advocate for the Minnesota Medical Foundation and Medical School alumni. He also maintained his international interests by serving as the Honorary Consul General of Japan for Minnesota.

I had the opportunity to meet with Dr. Gault several times over the past few years. He was well aware of the role of archives and the importance of preserving the historical record. Even during his tenure as dean, Dr. Gault personally and diligently transferred office records from the Medical School to the archives. I told him that his attention to record keeping must have been a result of his early training at Adjutant General School for the Air Force (after serving as Adjutant for a 1,000 bed hospital during the war at the age of 23).

Whenever Dr. Gault was asked what propelled him from rural Texas to an internationally renowned medical education specialist, he consistently answered that it was the opportunity for an education that he found at the University of Minnesota.


This machine kills

In November, the American Cancer Society sponsors its annual Great American Smokeout and the Lung Cancer Alliance designates November as National Lung Cancer Awareness Month.

The 1956 photograph below highlights early research at the University of Minnesota linking lung cancer with smoking. Dr. Harold S. Diehl, then Dean of the College of Medical Sciences, is showcasing a machine designed to chain smoke cigarettes in order to collect tar samples for research.

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A sign on the table explains that these “investigations are being carried out to study this apparent relationship” between smoking and lung cancer. A conical flask on the table collects the smoke pulled from the cigarettes.

Dr. Diehl retired as dean in 1958 after serving in the position since 1935. He then went to work full-time for the American Cancer Society as senior vice president for research and medical affairs and deputy executive vice president, a position he had held since November 1957. For ten years Diehl oversaw the ACS’s scientific research programs that bolstered policy positions aimed at reducing illnesses attributed to smoking.