Cancer center prospectus

In 1971, President Nixon famously began the “war on cancer” by signing the National Cancer Act. The Act, however, was not the beginning of the NIH’s attempt to promote cancer research and treatment but instead was a reinforcement of the goals of the National Cancer Institute founded in 1937. The 1971 Act expanded the budgetary and programmatic functions controlled from within the National Cancer Program and gave the director a direct line to the Office of the President outside of the NIH.

By the time of the 1971 National Cancer Act the University of Minnesota had spent 50 years of establishing cancer treatment and research through charitable giving.

img0133.jpgCancer treatment and care as a focus formally began in 1923 when the Citizens Aid Society led by Mrs. Carolyn McKnight Christian donated $250,000 to the University to open a 50-bed hospital for the treatment of cancer in honor of her husband, Mr. George Chase Christian. The gift also included money for the purchase of equipment and cobalt for radiation therapy. The Christian Wing was appended onto Elliot Memorial Hospital and is still structurally a part of the Mayo Memorial complex.

In the 1950s the Minnesota Masons followed suit with a campaign to establish an 80-bed facility with research space. Shortly after is successful completion in 1958 the Masons went on to raise the funds to add two additional floors to the facility and 50 more beds. The Masonic gifts to the University also included the establishment of an endowed Masonic Professorship in Cancer.

In 1958 the Veterans of Foreign Wars donated $300,000 for cancer research space at the University. The research facilities were built adjacent to the Masonic Memorial Cancer Hospital.

By the mid 1980s, the Medical School and those involved in cancer research in other disciplines began a push to establish a formal cancer center on campus. The University of Minnesota’s Cancer Center opened in 1991.

Read the 1988 prospectus for the Cancer Center below and note the emphasis on interdisciplinary programming.

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“It is vital to marshal knowledge of fundamental biology to resolve issues of cause, prevention, diagnosis and treatment.”


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.


8 is the loneliest number

img0129.jpg8 mm film, 8 track tapes, 8 inch floppy disks, all once promising media storage formats are for the most part gone from our daily use and even popular memory. Replaced by modern day equivalents of WAV files, MP3s, and cloud computing, our common media storage and delivery has moved from the tangible to intangible.

What is an archivist to do?

The time has come where archives and libraries are better equipped and staffed to manage the latter rather than the former. Maintaining AV rooms filled with half-working equipment for playback is a no win situation. Institutional repositories and internet based applications are better able to store, playback and preserve digitally created information than ever before.

A recent discovery of a box full of 8 inch floppies all marked as correspondence from the office of the Vice President for Health Sciences demonstrates the conundrum in the collection of historical documents. On the one hand, the content of the disks are absolutely central to the collecting focus for the History Project, yet on the other, the media is so obsolete and likely degraded to the point of being unable to retrieve any information.

The 8 inch floppy, like its successors the 5 in., 3.5in., Jaz and Zip disks, were tied to specific hardware operating systems. Yet, it often had multiple formats, disk densities, transfer rates, and spinning heads that made them even in their prime incompatible with other 8 inch disk drives. The ability to rescue data off any 8 inch diskette today would be beyond most IT skill sets and, due to the low data capacity they actually held, not worth the expense.

1980s computing taught us in the 1990s to fear the question of “how will I be able to save, read, open, edit this after the media, format, software, hardware changes?” However, in the last ten years the migration of electronic records has become easier to understand and to accomplish with only minor cautionary steps.

Changes in storage media will always challenge our preservation techniques and cause a few gaps in recorded history. This is to be expected and for the most part accepted as progress to better record keeping. I’m sure the first few recipes for baked clay tablets didn’t quite turn out as expected, yet I’ve never heard anyone mention cuneiform tablets as an unstable media.

So with this in mind I will look at my box of 8 inch floppies, and the information they might contain, and realize that this gap of documentation is an example of the jumps made from one media system to the next that is likely lost to history.


Why a university hospital?

Today, the Academic Health Center continues to partner with Fairview Health Services on a shared clinical mission. The recent report “Evaluating the Integration of the Clinical Enterprise” to the Regents demonstrates how this nearly thirteen-year old relationship continues to develop.

There is an interesting historical division between those who knew and worked within the University Hospitals and those who have only known Fairview as the owner/operator of the University of Minnesota Medical Center. For the latter, Fairview has always owned the hospital and University of Minnesota Physicians (UMP) has always been the faculty group practice.

Yet, this view seems to imply that the transition was spontaneous and effortless on January 1, 1997. In fact, the early part of the 1990s was a major time of restructuring within the AHC and in health services in general that set the stage for this change. This reorganization included a new mission for the Board of Governors as well as a closer alignment to the University of Minnesota Clinical Associates, the then faculty practice.

For a snapshot of where the University stood in 1993 read the executive summary below. Find out why a university hospital was important then. And, whether it was absolutely necessary that the University owned the hospital.

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When the Board of Regents formally reorganized the health sciences into the Academic Health Center in July of 1970 it appointed Dr. Lyle French, then head of neurosurgery, as Acting Vice President for Health Sciences. In March of 1971 the Regents removed “acting” from the title and made Dr. French a full vice president.

In 1976 Dr. French requested a review of his position by the Office of the President to evaluate its effectiveness. The final report was very complimentary of Dr. French and the success of the still relatively new position of Vice President for Health Sciences. In 1981, Dr. French stepped down from his position as Vice President and returned to teaching and research.

After eleven years, the Office of the Vice President for Health Sciences was set to become vacant and the first formal search to fill the position began. Below are draft copies of the job ads sent to the Chronicle and various professional journals. You’ll note that the position does not oversee the College of Veterinary Medicine. Although the 1970 reorganization aligned the CVM closely with the AHC, the reporting structure did not officially change until 1985.

The search concluded in 1982 when the Regents approved the appointment of Dr. Neal Vanselow, Chancellor of the University of Nebraska Medical Center, as the new Vice President for Health Sciences.

Read the job ads below. Would you have applied?

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Gross anatomy

From time to time, when sorting though boxes and folders of personal papers and office records, certain things will jump out at you as being out of place or not part of the original intention of the creator. Often times this addition to a collection is an unwanted biological guest like bugs or spiders (sometimes living but mostly dead), mold or mildew (usually dormant but sometimes active), and once I even saw the skeletal remains of a mouse (definitely an unintentional addition).

However, working with collections that focus on the health sciences, stumbling across a biological specimen is usually no accident at all. I’ve found random, unlabeled paraffin wax pathology samples as well as a wax cast of the inner ear (harvested post-mortem).

Today was a new anatomical sample in the archives. Inside this miniature cigar box were nearly two dozen envelopes containing extracted adult human teeth from the 1950s.

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Most had their full roots and represented all types of molars, bicuspids, and incisors.

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It was as if some contemptuous tooth fairy had stashed them away.


Pearl McIver

In the fall of 1918 the University of Minnesota Hospital was closed to all patients except those ill with influenza. This included the pediatric ward. At the time, Pearl McIver was a student nurse earning her practice hours during the pediatrics night shift.

According to McIver, the regulations of the unit required all personnel to wear a cap, mask and gown and restricted holding the children. The children were frightened and sick. Left alone on her first night, McIver removed her mask and cap and began wrapping each child and rocking them in her arms until they calmed down and took fluids. She would spend her night working her way through the ward of approximately 30 patients. One night, she was interrupted by an intern whom she thought would expose her. Instead, he offered to help. McIver kept her method of care during the influenza outbreak a secret for years until a chance meeting with the intern who was now a pediatrician.

McIver graduated from the School of Nursing in 1919 and continued to work at the University Hospital until taking a position with the United States Public Health Service in 1922. She retired in 1957 after serving as chief of the Division of Public Health Nursing.

Since then, her story has been told and re-told numerous times including by James Gray in his book Education for Nursing and Katherine Densford in her tribute piece to Pearl McIver in the April 1962 volume of the American Journal of Nursing. However, these two accounts are the re-telling of McIver’s story, paraphrased and embellished.

Below is a particularly poor mimeographed copy of the story that Pearl McIver dictated on July 3, 1958. It is the source used by both Gray and Densford, but it is her first-person account. The story as she told it.

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Iron lung

So where do you keep your Iron Lung?

img0122.jpgA common question among archivists and museum curators in the health sciences, the answer usually involves an off site location that can handle the nearly half-ton piece of equipment. This model belongs to the University of Minnesota and sits idle in warehouse off campus.

I haven’t been able to determine its date of manufacture. The Emerson Co. ceased production in 1970. Its model no. is R, serial no. W. A repair tag indicates the last service date was in 1978.

img0121.jpgThis model is likely from the 1950s. The early Emerson Iron Lungs from the 1930s were a baby blue color. The Smithsonian has the first Emerson model. The Minnesota Historical Society reportedly has a baby-blue Emerson in storage. J. H. Emerson became synonymous with the respirator after his less expensive model usurped the market from the Drinker Respirator developed at Harvard in 1929.

For most of us, looking at an Iron Lung stirs up a sense of claustrophobic restlessness. For those whose lives were saved by the device, a much more complicated set of feelings must be invoked. As of 2004, an estimated 40 people still relied on the respirators to survive.

The people who benefited from the Iron Lung did so with the help of others. They were not just placed inside and parked. The respirator was designed to be as portable as possible despite its weight and reliance on electricity.

A 1953 article in the Minnesotan, a publication for faculty & staff, details the behind the scenes work with the respirators at the University Hospitals. The article describes the care and upkeep of the machines, the planning and process to always have enough on hand at the height of polio outbreaks, and the ways in which patients and their respirators were moved and transported including the use of 50 foot extension cords to go from electrical outlet to outlet and police escorts. Learn more in the article below.

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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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