Skip to Content
Archives
NLM Home | About the Archives

NLM Home PageNLM Newsline Home Page
NLM Newsline Home PageContact NLMSite IndexSearch Our Web SiteNLM Home Page
Health InformationLibrary ServicesResearch ProgramsNew and NoteworthyGeneral Information

NLM Newsline 1999 January-March; Vol. 54, No. 1


In This Issue:

"Breath of Life" Exhibition Opens

LOCATORplus on the Web

Reading Room, Rotunda Update

bulletNGC Web Site Goes Live

African-American Health Issues, Voting Rights

Elizabeth Blackwell, M.D.

Worthy of Note

Louise Darling Dies at 87

Lederberg's Papers on "Profiles" Site

The "Difficult Woman"

MLA Time Capsule

HBCU Explores Internet

Older Adults and the Web


In Every Issue:

Names in the News

Products and Publications

NLM in Print



National Guideline Clearinghouse Web Site Goes Live on Internet


Information on Latest Clinical Practice Guidelines Now Available

National Guideline Clearinghouse (NGC), an exciting new free web- based library resource for up-to- date, evidence-based clinical practice guidelines, went live on the Internet December 15, 1998 at www.guideline.gov. Developed by the Agency for Health Care Policy and Research (AHCPR), in partnership with the American Medical Association and the American Association of Health Plans, the NGC is designed to promote quality health care by making available information on the latest clinical practice guidelines that are based on scientific evidence, all in one easy-to-access location.

The design of the NGC has incorporated previous research funded by the Department of Health and Human Services. The classification system for NGC is derived, in part, from NLM's Unified Medical Language System. Bi-directional links exist between NLM's PubMed and Health Services/Technology Assessment Text (HSTAT). The form of the structured abstract of clinical practice guidelines in NGC was based on research funded collaboratively between AHCPR and NLM. The definition of what constitutes a clinical practice guideline was taken from work completed by the Institute of Medicine under the sponsorship of AHCPR.

Development of clinical practice guidelines has grown rapidly over the last ten years. This growth reflects increased interest in improving the quality of clinical practice, reducing uncertainty and variability in health care decision making, and stemming rapidly increasing health care costs. However, many health care practitioners, health care systems, and health care purchasers have difficulty gaining access to and keeping abreast of the many clinical practice guidelines currently in use. This NGC web site is the first to provide free and comprehensive access to objective, detailed information on clinical practice guidelines.


African-American History Month Program Looks at Health Care Issues, Voting Rights

Civil Rights is the Common Denominator

NLM celebrated African-American History Month this year with a special program on February 11th in the Lister Hill Auditorium. Two speakers were featured. Former NLM visiting scholar Dr. David McBride now heads the African/African-American studies department at Penn State University. For the first half- hour of the program, he discussed "The African-American Medical Experience: Perspectives and Prospects." He was followed by Elena Temple, press secretary for Cong. Albert R. Wynn (D-MD). Temple filled in for her boss, who had to remain on Capitol Hill for a key Commerce Committee vote. She took a different tack from Dr. McBride's and discussed the importance of all Americans, and blacks in particular, exercising their right to vote.

In his thought-provoking lecture, Professor McBride examined the divide that exists between many in the black community and the medical establishment. He presented several troubling anecdotes of African-American persons' encounters with the medical establishment in the pre-civil rights era. In one, a girl named Audre had her first experience with medical care at the age of three or four. During an eye examination, a cold, unsmiling doctor offered no explanation as he subjected her to medical instruments and procedures that were strange and painful. Before leaving his office, the frightened child overheard the doctor and his colleagues discussing her "peculiar eyes" and the fact that "from the looks of her, she's probably simple, too." The little girl, who grew up to be poet Audre Lorde, was crestfallen. And those unpleasant moments at the doctor's office would shape her views of medical care for the rest of her life.

Such sentiments could be held by any one of the millions of African Americans reared in the pre-Civil Rights era, according to Dr. McBride.

"America has one of the largest and most scientifically advanced health care systems in the world," he said, "yet throughout its development, this medical care system has been unable to eliminate serious gaps in the health status of America's largest racial minority, African Americans." To illustrate his point, McBride noted that in 1985 it was estimated that about 60,000 excess deaths occurred among blacks, compared to whites. By 1990, the figure had actually risen, to at least 80,000. These discrepancies persist today, he explained, due to higher rates of cancer, heart disease, stroke, diabetes, homicide and HIV among the black population. The author of several books on health inequities among minority populations, McBride has devoted much of his career to researching why so many African Americans have fallen through the cracks of the U.S. health care system and how improvements can be made in the future.

Praising the government's recently announced $400 million effort to end disparities in health care by 2010, McBride said that two strategies could go a long way toward closing the gaps in the U.S. medical care system: development of more and better preventive medicine models and increased involvement on the part of community and private industry leaders. Elected in 1992, Rep. Albert Wynn currently serves on the Commerce Committee, where he is a member of the Subcommittee on Telecommunications, Trade and Consumer Protection, as well as the Energy and Power Subcommittee. He is also a Deputy Democratic Whip and a member of the Democratic Message Group. Speaking on his behalf, his press secretary, Elena Temple, talked about the long, difficult struggle of African Americans to achieve equal voting rights. She urged their descendants not to take the right to vote for granted. She also refuted an untrue rumor that is circulating via e-mail and other media, that the 1965 Voting Rights Act and the 15th amendment to the Constitution will expire in 2007, leaving blacks without the right to vote.

Temple urged her audience not to worry about preserving access to the voting booth, but to make the best use of the access already provided and guaranteed. "Assess your values, assess your actions," she said in closing. "Our enemy in the new millennium is apathy."


"That Girl There Is Doctor in Medicine"

Exhibit Examines Triumphs, Trials of Elizabeth Blackwell, M.D.

One hundred and fifty years ago, on January 23, 1849, a young woman ascended the platform of the Presbyterian church in Geneva, N.Y., and received from the hands of the President of Geneva Medical College a diploma conferring upon her the degree of Doctor of Medicine. Thus, after many years of determined effort, Elizabeth Blackwell became the first woman to complete a course of study at a medical college and receive the M.D. degree.

In commemoration of this event, the National Library of Medicine has mounted an exhibit entitled "'That Girl There Is Doctor in Medicine': Elizabeth Blackwell, America's First Woman M.D." The exhibit, curated by Carol Clausen of the Library's History of Medicine Division (HMD), is located at the entrance to the HMD Reading Room, just off the NLM lobby (Building 38). Items illustrating Blackwell's admission to medical school, her experiences as a medical student, her graduation, and her subsequent medical career are displayed.

When her initial attempts to gain admission to a well-established medical school met with failure, Elizabeth persevered, applying to a dozen smaller colleges. As she recounted in her autobiography, Pioneer Work in Opening the Medical Profession to Women, "At last, to my immense relief (though not surprise, for failure never seemed possible), I received the following letter from the medical department of a small university town in the western part of the State of New York." The single acceptance came from Geneva Medical College in Geneva, N.Y. Accompanying the letter from the Dean was a resolution by the students, affirming their support of her endeavors. Displayed in the exhibit is a formal copy on parchment of the acceptance letter and resolution, which Blackwell had copied from the original and esteemed as "one of my most valued possessions."

The exhibit includes items illustrating Blackwell's life as a student at Geneva Medical College, including a set of her class notes on materia medica, pictures of the Geneva College buildings, a College circular, and class admission tickets. Most intriguing is the manuscript syllabus of James Webster, professor of anatomy and Elizabeth's strongest supporter. In her diary Elizabeth describes an anatomy class on a day soon after her arrival as "a trying day ... a terrible ordeal ... Some of the students blushed, some were hysterical ... My delicacy was certainly shocked ..." The syllabus reveals the source of embarrassment.

The academic career begun with such difficulty was completed in triumph. Elizabeth had gained the support of the students, faculty, and townspeople, and graduated first in her class. Her brother Henry, who attended the graduation, described the ceremony in a letter to his family and noted the special esteem in which she was held. In his address to the graduating class, printed as a brochure, Dean Charles A. Lee commended Elizabeth's "perseverance under difficulties, and obstacles next to insurmountable." Her thesis, on ship fever (i.e. typhus), was given the unusual honor of publication in the Buffalo Medical Journal.

After two years of further study in Paris and London, Blackwell settled in New York City. Her efforts to establish a medical practice were met by what she described as "a blank wall of social and professional antagonism." Instead, she turned to social and hygienic reform and the promotion of the medical education of women. She founded a free clinic, the New York Infirmary for Women and Children, which still exists as the New York Infirmary/Beekman Downtown Hospital, and the Woman's Medical College of the New York Infirmary. The exhibit includes circulars and catalogues from both of these institutions, some of Blackwell's own publications, and several portraits of her.

Flyers about the exhibit are available at the NLM or by mail from the History of Medicine Division, National Library of Medicine, Bethesda, MD 20894. The exhibit will be on display until June 30, 1999.

Thanks to Carol Clausen, HMD Librarian, for contributing this article.

carol.gif - 62.5 K

Caption:
Curator Carol Clausen (second from left) shows the Elizabeth Blackwell exhibition to three distinguished holders of degrees from Hobart and William Smith Colleges. Dr. Blackwell's medical college was affiliated with Geneva College, the forerunner of those two schools. Pictured with Ms. Clausen are (from left): Steven J. Phillips, MD (Hobart '62), consultant to the NLM Board of Regents and Medical Director, Iowa Heart Center, Des Moines; NLM Board of Regents Chair Dr. Tenley E. Albright (honorary doctorate from Hobart and William Smith, '65); and Kent A. Smith, NLM Deputy Director (Hobart '60).



Worthy of Note

A recent case report in the journal Lancet (Feb. 6, 1999, p. 462 - see full reference in "NLM in Print," below) mentions the successful MEDLINE search conducted by an intern at the Department of Medicine, Kaplan Medical Centre, Rehovot, Israel. A recent citation in the NLM database helped the young doctor unlock the secret of an otherwise healthy 24-year-old student suffering from bloody diarrhea, abdominal pain, vomiting and weight loss. The patient was determined to have superimposed cytomegalovirus (CMV) colitis presenting as a flare-up of her ulcerative colitis (similar to the case reported in the MEDLINE reference). Ganciclovir was administered intravenously twice a day for 21 days and the patient eventually regained her health and displayed a weight gain of 10%. (This article, by Ami Schattner, is titled, "Medline solution.")

The University of Pennsylvania Cancer Centers' online database, Oncolink, presented its Editor's Choice award for January 1999 to MEDLINEplus, NLM's new online site for consumers. The award is made on a regular basis to the providers of the highest quality cancer information on the Internet. "We wanted you to know that the reason for the selection is the particular emphasis we at OncoLink place on patients and families who empower themselves with information about cancer and cancer prevention. Your site is exemplary of this philosophy."


Louise Darling Dies at 87

Founding Librarian of UCLA Biomedical Library Was Frequent Collaborator with NLM

Louise M. Darling, founding librarian of the UCLA Biomedical Library, died March 21, 1999 at the age of 87. Miss Darling set up the first decentralized MEDLARS search center in 1965. She was also one of the original Regional Medical Library Directors in the National Network of Libraries of Medicine, establishing the Pacific Southwest Regional Medical Library Service in 1969.

Miss Darling was serving in the U.S. Army Library Service in the Philippines when, in 1947, UCLA University Librarian Lawrence Powell asked her to come to the school to establish the new Biomedical Library. She guided this multidisciplinary library until her retirement in 1978. In 1987, the library was renamed in her honor, to recognize her many years of dedication and service.

darling.gif - 36.9 K

Caption:
This 1954 photograph of Louise Darling shows the pioneering librarian perusing a Vesalius text. (Courtesy of Louise M. Darling Biomedical Library, UCLA.)

During her long and distinguished career, Miss Darling served the profession in many capacities, including as President of the Medical Library Association in 1963-64, and received many awards. MLA's Louise Darling Medal for Distinguished Achievement in the Collection Development in the Health Sciences was established in her honor. As the UCLA press release about her death noted, [the Darling Library's] "distinguished collections bear witness to Darling's personal interest in collection development, but her primary concern throughout her long career was people: library users and especially the staff who provide service to them." Miss Darling had a major interest in the education of health sciences librarians and created a highly successful internship program at the UCLA Biomedical Library. At the request of Martin M. Cummings, then NLM Director, she conducted a review of NLM's Associate Program shortly after her retirement from UCLA, which served as a basis for major changes in the program.

 

Although her accomplishments spanned virtually all areas of medical librarianship, including pioneering efforts in library automation, Miss Darling's most important contribution may have been her ability to recognize, train, develop, and encourage future leaders. Many of those who began their careers as interns or staff members in Miss Darling's library later served NLM directly as employees, Regional Medical Library Directors, and members of advisory groups and planning panels. This distinguished group includes but is by no means limited to: Lois Ann Colaianni, former NLM Associate Director for Library Operations; Anthony Aguirre, Director, Taubman Medical Library, University of Michigan; Robert M. Braude, Ph.D., Director, Cornell Medical Library; Naomi Broering, Director, Houston Academy of Medicine - Texas Medical Center Library; Alison Bunting, Associate University Librarian for Sciences, UCLA; Sherrilynne Fuller, Ph.D, Acting Director, Informatics, University of Washington; Phyllis Mirsky, Acting University Librarian, University of California, San Diego; the late Daniel T. Richards, former Director, Dartmouth College Biomedical Library; and Gloria Werner, University Librarian, UCLA.

Next article

Select another issue

Cumulative Index


Last updated: 20 September 1999
First published: 01 January 1999
Permanence level: Permanent: Stable Content


U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894
National Institutes of Health, Department of Health & Human Services
Copyright, Privacy, Accessibility
Last updated: 22 September 1999