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Libraries have existed for many years, though ancient and medieval libraries operated differently than libraries today. Unfortunately, for many centuries, libraries were not accessible to everyone in society and only members of the elite classes (such as monarchs, religious leaders, or wealthy individuals) had the ability to use ancient libraries. The history of medical libraries is closely intertwined with the broader history of libraries. While many ancient civilizations created and archived medical texts, medical libraries as we know them today have only existed for a few centuries. To better understand the foundations of modern medical libraries, it is important to begin with the earliest foundations of all libraries.

Libraries in the Ancient World:

Image of the columns of a ruin and dry brush in the foreground.

Professor Michael H. Harris wrote in History of Libraries in the Western World “Conceivably, it should be possible to decide just when and where the first library originated, but all we know is that at certain times and in certain locations early libraries existed.” (Harris, 1999, pg. 7) Many of the manuscripts that once existed in ancient libraries are no longer available. Historians know of these lost texts by references made in other works. 

Despite the inconsistent access to primary sources, historians have been able to determine some characteristics of older libraries. For example, archeological and historical discoveries reveal that there were three common writing surfaces used in the ancient world: papyrus, parchment and the clay tablet. (Harris, 1999) . These texts were typically stored in jars or on open shelves. There was also a classification system so items could be easily retrieved, though these classification systems varied from location to location. 

One of the earlier libraries was located in the Assyrian civilization. The library of King Assurbanipal consisted of over 30,000 tablets which covered a range of subjects, including medicine and medical procedures. “Several hundred of the tablets cover medical matters and give details of medical practices; others are on the borderline between medicine and magic arts.” (Birchette, 1973, pg. 302) Staff members helped run the library and the library was open to scholars within the kingdom. (Harris, 1999) There was also an organization system used in the library: “The clay tablets inside the rooms of Assurbanipal’s library were kept in earthen jars, and the jars in turn were kept in orderly rows on shelves. Each tablet bore an identification tag, indicating the jar, shelf and room of its location. On the walls of each room, beside the door, was a list of the works to be found in that room.” (Harris, 1999, pg. 19)

The library of Assurbanipal provides a glimpse of what libraries were like millennia ago. Similar institutions could be found in other civilizations in Egypt, Greece and Rome.

Medieval Libraries:

After the collapse of the western Roman Empire in 476 there was a decline in learning and a general societal stagnation in many parts of Europe. During this time, Middle Eastern civilizations flourished culturally and served as the center of learning. Scholars note that there are several reasons why medieval Muslim civilizations became a central hub for learning. Some of these reasons include the inexpensive cost of manuscript books, relatively high literacy rates among the upper and middle classes and the centrality of books to the Islamic faith. (Walbridge, 2016) Medical centers existed in cities like Salerno and Cordova and research shows that libraries at this time contained massive collections. “At their finest, Islamic libraries were large, well-organized institutions with specially built facilities for book storage and reading, professional staff, regular budgets and endowments, catalogs, and even lodging and stipends for visiting scholars.” (Walbridge, 2016, pg. 2)

An overlook shot of a ruin structure made out of stones.

While there was a lack of cultural growth in Europe during the early periods of the Middle Ages, the rise of Christian monasticism began in the 500s and the newly built monasteries continued the work of ancient libraries. The libraries in monasteries were much smaller in size and scope than libraries in the Islamic or ancient worlds. Not only were monasteries places where people could study and reflect on religious texts in seclusion, but they also served as places to care for the sick. “The monastery of Monte Cassino in Italy, founded in 529 by St. Benedict, was one of the first monasteries to assume the responsibility for nursing the sick.” (Birchette, 1973, pg. 304) Additionally, Cassiodorus, an influential figure in the monastic tradition, “felt it was very important that a Christian should study the medical practices of the past in order to prepare himself for the care of the sick. As a result of his feelings toward medical knowledge, Cassiodorus began to collect for the use of the monks all available medical and philosophical manuscripts both in his monastery and at Monte Cassino.” (Birchette, 1973, pg. 305)

During the medieval period, religions heavily influenced libraries and the curation of their collections. While medical texts were present in both Islamic libraries and Christian monasteries, these texts existed within larger general collections. With the rise of universities and a renewed interest in education and learning, there was a gradual shift in the organization of libraries and soon medical texts would exist in their own collections.

The University Library:

Universities began to emerge in the Western World around the 12th century and with the rise of these institutions, libraries once again began to change to fit the needs of these new crop of scholars. Many early universities did not have the funds to establish a central library. As such instructors frequently opened up their private collections to their students. Alternatively, students would keep books in a communal area and money would be collected for the purchase of new books. 

Two documented instances of medical libraries were the libraries located at the University of Florence and the University of Paris. (Birchette, 1973) As with all other university libraries, the development of medical libraries was slow for many years. “Not until printed books became common did the library book stocks reach into the thousands.” (Harris, 1999, pg. 79) Private book collections were a common practice for those who could afford to frequently purchase books and these private collections sometimes became the foundations for many early university libraries. 

A stone walkway leading to a building's gated entrance. The iron gates are open.

When European countries began to colonize the Americas, colonial figures brought over their private collections. John Winthrop who lived in the Massachusetts Bay Colony is credited with one of the earliest medical collections in the United States. In 1812, his collection went to the New York Hospital, before eventually moving to the New York Academy of Medicine. The Pennsylvania Hospital Library is the oldest medical library in the United States and by 1856, its collection contained over 10,000 volumes. (Birchette, 1973) In the 1800s, more medical libraries were established in the United States and near the end of the century, there were an estimated 120 medical libraries in the country. (Birchette, 1973)

Modern Libraries:

After 1850, the growth of libraries in the United States increased significantly. “Using economic terms, the “take off” in the development of American libraries can be said to have occurred between 1850 and 1900, and by the latter date most of the library forms known to modern librarians were firmly established and their patterns of development clearly visible.” (Harris, 1999, pg. 165) From 1850 onward, there was an intentional and systematic development of libraries in the United States and other parts of the Western world. These libraries soon became the institutions we are familiar with today. 

In 1898, the Association of Medical Librarians (now known as the Medical Library Association) was founded by four librarians and four physicians. The purpose of this association “was the fostering of medical libraries and the maintenance of an exchange of medical literature among its members.” (Medical Library Association, 2023)  Several years earlier, in 1836 the Library of the Office of the Surgeon General of the Army was established and in 1956, Congress voted to rename this the National Library of Medicine. 

In the 1900s, special department or college libraries were established as many university libraries became too large to effectively maintain. Libraries in hospitals also grew during this time. Hospital libraries served both health sciences professionals and their patients, providing technical, medical texts and consumer health resources. Special libraries such as medical school and hospital libraries are typically smaller than public or general university libraries. But the subject specificity of these libraries are greatly valued by fields like the health sciences. Harris noted that special libraries “can often experiment with new ideas, new methods, new technologies, and new services more easily than the older, larger, and more standardized libraries.” (Harris, 1999, pg. 189) Examples of this include the National Library of Medicine’s PubMed database or the consumer health website, MedlinePlus.

Image of communal tables and study spaces in Himmelfarb library.

The development of libraries has a long history and at different points, certain groups worked to preserve literature, culture and share that information with the select elite. While this history spans multiple countries and points in time, it is important to note the limitations of this Western perspective. The history of libraries focuses primarily on Western Europe and the Americas after colonization. Thus this history is only a sliver of the larger story of libraries in the world. 

If you wish to learn more about libraries, please read one of the references listed below. Or seek out alternative perspectives, such as ‘History and status of Native Americans in librarianship’ by Lotsee Patterson, ‘Stories told but yet unfinished: Challenges facing African American libraries and special collections in historically black colleges and universities’ by Irene Owens or ‘The History and status of Chinese Americans in librarianship’ by Mengxiong Liu. 

References: 

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Himmelfarb Library has an extensive collection of online books, journal articles, and multimedia materials. These resources can be accessed from both on- and off-campus locations. To ensure consistent access to e-resources from off-campus locations, a durable link may be required. Durable links provide consistent access to electronic journals, articles, books and other materials by ensuring that GW users are recognized and can access library collections. If you are a faculty member preparing for the start of a new semester, Himmelfarb Library’s Durable Link Service can assist you with embedding durable links into your syllabus and other course materials which will provide your students with reliable access to course materials. 

Durable links are URLs that directly connect users with Himmelfarb Library’s electronic resources. These links are reliable and allow faculty members to share resources with students and avoid copyright violations. 

There are four ways to create durable links:

  • Attach a proxy prefix
  • Use a permalink
  • Link by PMID, DOI, ISBN or ISSN
  • Link to databases

 You can attach a proxy prefix to a resource’s URL which will route the link through GW’s systems and authenticate users as needed. Himmelfarb’s proxy prefix quick tool will automatically generate a link with the required proxy prefix. The tool also allows you to test the link prior to adding it to your syllabus or Blackboard course so you are confident that the URL works. 

Himmelfarb’s catalog records have an option to create a permalink for a resource. Search for the resource in the catalog and select the ‘Permalink’ button under ‘Send to.’

This option will direct your students to the resource in the catalog where they can open the item’s full text. Databases such as EBSCO, Ovid and Proquest also have ‘Permalink’ features that can be given to students. 

If you have the PMID, DOI, ISBN or other unique identifier for a resource, you may use this to create a durable link. For example, if you have the DOI for a journal article, you may append it to http://himmelfarb.gwu.edu/doi/ to link directly to the article (e.g. http://himmelfarb.gwu.edu/doi/10.1016/j.jadohealth.2021.11.035). For more examples please see the ‘Link by PMID, DOI, ISBN or ISSN’ section on our Linking to Electronic Resources: Creating Durable Links guide. 

Last, you may link directly to databases. Visit the A-Z List: Databases page, search for the specific database and click the connected dots symbol to the right. A small window will open with a durable link which will connect users to the database’s homepage. 

If you have questions about durable links or if you would like assistance with creating links, Himmelfarb Library is here to help! Our Linking to Electronic Resources: Creating Durable Links guide provides examples and additional information about durable links. Additionally, library staff members will check for broken links, generate new links and embed them onto your syllabus or Blackboard course. Send your syllabus or question to himmelfarb@gwu.edu and a staff member will provide more information.

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It has been over a year since the Supreme Court issued its decision in the case Dobbs v. Jackson Women’s Health Organization. The Dobbs decision overturned the 1973 Roe v. Wade opinion and determined that the U.S. Constitution does not confer a right to abortion and returned the authority to regulate abortion to individual states.  Currently, 15 states have laws that prevent access to abortion and 11 other states impose a gestational limit on abortion care. (Abortion Policy Tracker, 2023) Due to the patchwork of state laws and local ordinances that cover abortions, individuals with reproductive healthcare needs may encounter difficulties when searching for the best care or they may face barriers in accessing information about abortion. These barriers impact an individual’s overall health and can feed into our larger understanding and acceptance of abortion, reproductive health and reproductive justice. 

Researchers created the term ‘abortion stigma’ to explain how the silence and wariness around discussing abortion impacts individuals, healthcare providers, activists and others. Barbara Alvarez writes “When people can’t access credible health information, they can’t make the best decisions for their mental and physical wellbeing. That’s why the World Health Organization (WHO) includes information access as one of its three cornerstones for comprehensive abortion care.” (Alvarez, 2022, para. 1) Dismantling ‘abortion stigma’ is not only a healthcare concern, but also an information access concern that healthcare and information professionals should address.

Kumar, Hessini & Mitchell define abortion stigma “as a negative attribute ascribed to women who seek to terminate pregnancy that makes them, internally or externally, as inferior to ideals of womanhood.” (Kumar, Hessini & Mitchell, 2009, pg. 628) The authors also note that abortion stigma “is a social phenomenon that is constructed and reproduced locally through various pathways.” (Kumar, Hessini & Mitchell, 2009, pg. 628) Norris et al. expands this definition so that it includes others who are impacted by this form of stigma. “Secrecy and disclosure of abortion often pertain to women who have had abortions, but may also apply to other groups–including abortion providers, partners of women who have had abortions, and others–who must also manage information about their relationship to abortion.” (Norris et al., 2011, pg. S50) 

There are layers to abortion stigma and how it appears in people’s lives. For example, Norris et al. note that “Legal restrictions (e.g., parental consent requirements, gestational limits, waiting periods, and mandated ultrasound viewing) in the United States make it more difficult for women to obtain abortions and reinforce the notion that abortion is morally wrong.” (Norris et al., 2011, pg. S51) Abortion stigma may prevent healthcare professionals from pursuing coursework or a career in abortion care or this stigma may have a negative impact on the health of the provider. “Physicians who are trained to but do not provide abortions describe explicit and subtle practice restrictions and fear of repercussions from colleagues.” (Norris et al., 2011, pg. S51) Information specialists, such as librarians and other library professionals, may also hesitate to include information about abortion in their institutions’ collection because the inclusion of these resources may be challenged. Or, they may be unaware of the need for abortion resources as abortion stigma and library anxiety compounds and prevents patrons from seeking assistance from librarians or other staff members. “I received feedback from librarians that described the post-Dobbs landscape: they replied that patrons may have “fear and uncertainty of how to protect [themselves] if [they] are seeking abortions services.”” (Alvarez, 2023, para. 3)

Without reliable access to accurate information, people cannot make informed decisions about their health. This information is also important because it challenges the negative connotations associated with abortion or other stigmatized procedures. Norris et al. proposed that normalizing abortion as a solution to dismantling this stigma: “We should engage popular media, including popular entertainment, in the effort to remind people that abortion is common and usual.” (Norris et al., 2011, pg. S53) One way of doing this is by eliminating restrictions in information access and affirming the basic right to information and intellectual freedom. “...although there are many ways to approach intellectual freedom in libraries, there is often a common theme of human dignity that appears either explicitly or between-the-lines…all of these perspectives rely on the autonomy of each patron and their ability to exercise that autonomy.” (Childs, 2017, pg. 65)

If you wish to participate in the dismantling of abortion stigma, organizations such as the Guttmacher Institute, SisterSong Women of Color Reproductive Justice Collective, KFF provide resources on abortion, current legislation and other key pieces of information. These organizations will equip you with information to navigate conversations on abortion and reproductive justice.

Additionally, if you are interested in learning more about intellectual freedom and would like to assist library professionals with building inclusive collections, the American Library Association (ALA) has dedicated resources available. Their Intellectual Freedom: Issues and Resources page is an excellent starting point. Or, you can learn how to support library workers as they work to ensure intellectual freedom within their institutions by visiting the ALA’s Fight Censorship page. 

Finally, Himmelfarb Library has materials on reproductive health and reproductive justice. For assistance answering specific questions or finding resources, use our Ask a Librarian service to speak with a reference specialist who can connect you with resources. 

Dismantling abortion stigma requires a collaboration between healthcare and information professionals. If people are required to make decisions about their reproductive health, they must have access to information without undue restrictions. By working together to address this stigma, healthcare and information professionals can empower people to make informed decisions.

References:

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Photograph of a person reading a red book

On June 19, 1865 Union General Gordon Granger along with a band of soldiers arrived in Galveston, Texas, one of the furthest corners of the former Confederacy. The general informed the enslaved people in town that by order of President Abraham Lincoln’s 1863 Emancipation Proclamation, slavery was no longer legal within Confederate territories and that they were now free. The following year, on June 19, 1866 the freed people of Galveston organized a celebration to commemorate the ending of slavery within the United States. This event eventually became one of the most important holidays for African-Americans across the country. 

Known as ‘Freedom Day,’ ‘Emancipation Day,’ or most commonly as ‘Juneteenth’, June 19th marked a significant moment in American history and within the African-American community. With the issuance of the Emancipation Proclamation in 1863 and the ratification of the 13th Amendment near the end of 1865, the institution of slavery was formally ended in the United States. In Texas and other Southern states, Juneteenth became an annual celebration as freed African-Americans shared meals, read the Emancipation Proclamation aloud, registered new voters, and shared their visions for the development of the community. 

During the Great Migration, a period in the 1900s when many Southern African-Americans moved to the Northeast, Midwest or West, the tradition of Juneteenth celebrations was spread to other parts of the country. For decades, Juneteenth was only recognized and celebrated by African-Americans, but with time, the community began to advocate for state and federal governments to honor the day. In 1979, Texas officially declared Juneteenth an official holiday, making it the first state to recognize the date. Since then, more and more states have recognized Juneteenth in some official capacity. In 2021, President Joe Biden signed the Juneteenth National Independence Day Act which designated Juneteenth as a federal holiday, making it the 11th federally recognized holiday. 

While Galveston, Texas remains a central location for Juneteenth celebrations, other cities such as Atlanta, Georgia, Philadelphia, Pennsylvania, and Washington D.C. also hold events that hundreds or thousands of people attend each year. Events still feature food and music, but some cities also host Juneteenth pageants, rodeos, and lectures that all showcase the rich culture of the community. 

If you are interested in honoring Juneteenth, Monday, June 19th is the last day to see the Emancipation Proclamation and General Granger’s General Order No. 3 on display at the National Archives museum! The museum is open from 10:00 AM through 5:30 PM and there is no entry fee. There will also be a free community event at the Black Lives Matter Plaza on June 19th. The event starts at noon and will feature music, games, a kid zone, and other activities. Last, the National Museum of African American History & Culture curated a ‘Juneteenth Reading List’ filled with fictional, historical, biographical, and autobiographical texts to help people learn more about Juneteenth and the period after slavery. 

Juneteenth is considered one of the oldest celebrations within the African-American community. It marked the beginning of freedom and self-actualization for formerly enslaved people. Even today, families spend time reflecting on the legacy of slavery and the continual fight for civil rights. To hear a personal anecdote about the importance of Juneteenth, please watch this short video from GW Associate Professor Imani Cheers:

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In the United States, June is designated as LGBTQ+ Pride Month in recognition of the 1969 Stonewall uprising in Greenwich Village. For many activists and historians, the 1969 uprising represented a turning point in LGTBQ+ history and activism. While LGTBQ+ people have more legal and social rights in the aftermath of Stonewall, organizations, communities and activists within the United States and around the world continue to push for protections that ensure LGBTQ+ people can live freely. 

Recently, the Human Rights Campaign (HRC) released a ‘State of Emergency’ for LGBTQ+ people living in the United States. In their release the organization said “The sharp rise in anti-LGBTQ+ measures has spawned a dizzying patchwork of discriminatory state laws that have created increasingly hostile and dangerous environments for LGBTQ+ people…” (Human Rights Campaign, 2023)

Despite the rise in anti-LGBTQ+ legislation, people embrace June as a month reserved for celebration and community. As journalist Erin Reed wrote, “We carry forward a potent legacy, one of not merely surviving but flourishing even in the margins where we’ve been relegated. We return, time and time again, stronger than ever before…The essence of queer joy is resistance in its own right, and the reverberations of the Stonewall resistance continue to echo in our celebrations today.” (Reed, 2023) 

There are many ways to celebrate Pride month! Whether it is reading a book centering LGBTQ+ narratives, attending a local Pride event or watching a documentary, the following list serves as a starting point for celebrating and uplifting the LGBTQ+ community this month and all year long!

A person holding a cut out of a rainbow colored heart
Photo credit: Photo by Pavel Danilyuk

Books:

Reading books written by LGBTQ+ authors or that feature LGBTQ+ characters is an excellent way to celebrate Pride and feel connected to the community. They are a plethora of books that span genres. If you’re not sure where to begin, consider turning to sources such as the Lambda Literary Awards or the Stonewall Book Awards lists that have recognized LGBTQ fiction and non-fiction for years. Or start with some of the following titles: 

For additional community building, consider organizing a book club with your peers. You can select one title to read together and hold a discussion. Or each member of the book club can commit to reading a different book that was written by an LGTBQ+ author and make their pitch as to why the other members should read it as well! 

Documentaries:

Watching documentaries is another way to celebrate Pride this year! Similar to the book club suggestion, you can hold a documentary watch party and discussion to share any insights you have after viewing the film. Some titles that may be worth watching include Paris is Burning  an intimate look at New York City’s drag and ballroom culture in the 1980s; A Secret Love a film about Terry Donahue, Pat Henschel and their decades long love story; Disclosure that explores the depiction of transgender people in cinema; or United in Anger: A History of ACT UP which looks at the rise of the AIDS activist movement.

For additional recommendations on LGBTQ+ documentaries, please see Advocate’s 32 LGBTQ+ Documentaries to Watch for LGBTQ+ History Month, Collider’s Queer History is Pride: 11 of the Best LGBTQ Documentaries or Rotten Tomatoes’ 40 Essential LGBTQ+ Documentaries. 

Local Events:

Washington D.C. and the surrounding area is home to an active and vibrant LGBTQ+ community. Each June the city is nearly bursting with activities to meet new people, learn about the history of Pride or celebrate with your friends. The most popular event is the annual Capital Pride parade and festival which took place this past weekend. But there are still numerous opportunities to celebrate Pride in the area. 

On June 14, As You Are will hold its inaugural Queer Open Mic Night where writers, musicians, comedians and others can share their work! Want to shop for books and meet local readers? Then purchase a ticket for Little District Books’ June 22 Pride Party. The National Portrait Gallery will host an online conversation titled ‘Sexuality and the Harlem Renaissance’ on June 20. Near the end of June, The DC Mayor’s Office will present this year’s District of Pride Showcase at Lincoln Theatre!

Looking for other Pride events in the area? Check out the Pride guides from DC Trans Events, Clock Out DC or Queer Talk DC!

Volunteer:

If you want to give to the LGBTQ+ community, there are local and national organizations in need of volunteers. The DC Center for the LGBT Community sponsors local volunteer opportunities throughout the year. Or become a volunteer for organizations like The Trevor Project, the Human Rights Campaign or PFLAG!

If you are interested in organizing an event at George Washington University, Himmelfarb Library’s Diversity, Equity and Inclusion Committee is open to partnering with student, resident or faculty groups! Please contact the committee’s current chair, Rachel Brill at rgbrill@gwu.edu for more information! 

Whether you are a member of the LGBTQ+ community or an active ally, Pride month is a time to connect with our loved ones and celebrate strides gained through activism. It is also a month where we recognize the many contributions the community has made to our contemporary culture. No matter how you decide to celebrate Pride, what is most important is that we collectively work to build a world where people, regardless of their sexual orientation, gender or gender expression can live as their most authentic selves!

References: 

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Black and white photo of a military medic kneeling in front of cabinet of medical supplies.
Photo and caption via National Archives Catalog: A military medic kneels in front of a shelves full of variety of medicine bottles

Health care personnel have assisted military units for centuries, both in unofficial capacities and as recognized members of the armed forces. Whether they were actively treating injured soldiers on the frontline or performing complex surgeries in military hospitals, physicians, surgeons, nurses and other health professionals worked alongside soldiers and commanders to ensure that the injured were properly treated. 

Prior to the 19th and 20th centuries, healthcare treatment within the military was largely decentralized and relied on inaccurate information on wound treatment and patient care management. But as more advanced weapons and military tactics were introduced, countries and military leaders invested in their healthcare infrastructure which led to lower mortality rates and the decrease of widespread infection within military camps. Many of the inventions introduced during conflicts such as the Napoleonic Wars, the American Civil War and the World Wars have been carefully refined and serve as the foundation for today’s current military medicine practices. 

Health and medicine have been the focus of research for centuries. Many ancient historical figures and civilizations documented their theories about human anatomy, physiology, the nature of diseases and health remedies. Preserved historical texts from ancient civilizations provide us with a glimpse of some of the health treatments and theories proposed by scholars. In Homer’s The Iliad, surgeons were portrayed as “skilled and professional physicians who expertly treated wartime trauma.” (Manring et al., 2009, pg. 2173) Ancient Egyptians and Babylonian-Assyrians left behind texts and treatises that showed cultures with sophisticated and thoughtful ideas about medicine and the human body. (Van Way, 2016)

During the time of the Roman Empire, “The Roman army had organized field sanitation, well-designed camps, and separate companies of what we would now call field engineers. They had a much better grasp of sanitation and supply than anyone else before, or for a long while.” (Van Way, 2016, pg. 260) While ancient civilizations lacked the technology and scientific theories that form the foundation of modern medicine, these cultures worked to protect their injured soldiers during battle. Some civilizations, such as the Romans, understood the importance of maintaining clean environments to prevent epidemics from debilitating their armed forces. As Dr. Charles Van Way III wrote, “Because of their [The Romans] improved sanitation, their armies suffered somewhat less from the epidemics which swept military camps, but only by comparison with their opponents.” (Van Way, 2016, pg. 261)

Color image of temple ruins.
Photo Credit: Edneil Jocusol via Pexels.com:

Unfortunately, when the Roman Empire fell, their ideas on sanitation and healthcare management were lost. For years, there were few scientific advances and many physicians relied on the ancient and incorrect humoral theory or four humors theory which was first suggested by the Ancient Greeks. According to this theory, the human body consisted of four ‘humors’: black bile, yellow bile, blood and phlegm. If a person was ill, humoral theorists believed the sickness was caused by an imbalance of humors within the body, instead of pathogens or forces outside the body. While there are some critics of this theory, it was the prevailing medical belief until the 18th and 19th centuries. 

With the development of the scientific method around the 17th century, empirical observations became the basis for theories; the humoral theory eventually fell out of favor and more evidence-based practices/theories took its place. This impacted military medicine as healthcare responders developed new techniques that contributed to declining mortality rates and a more sanitary wound treatment management system. 

Some discoveries and resources that were developed during this time include Jean Louis Petit’s tourniquet, Pierre-Joseph Desault’s description of the debridement of wounds and the publication of three textbooks on military medicine. (Van Way, 2016, pg. 262) But it was during the Napoleonic Wars (1792-1815) where military medicine began to improve and leaders recognized the importance of a well maintained military healthcare system. Baron Dominique-Jean Larrey is seen as the originator of modern military medicine. Some of his contributions to the field include an early framework for the triage system, the “ambulance volante” or flying ambulance and the use of field hospitals that were located away from the battlefield. (Van Way, 2016; Manring et al., 2009)

Despite the recommendations created by Baron Dominique-Jean Larrey, armies still failed to create an organized healthcare system within their military. This caused controversy during some campaigns. For example, during the American Civil War (1861-1865) both the Union and Confederate armies “had physicians, but there was only a rudimentary hospital and evacuation system…Public health was terrible. Many soldiers died of disease, often even before reaching the battlefield.” (Van Way, 2016, pg. 336) This eventually led to the establishment of a military medical corps that treated the injured soldiers. And during the Crimean War (1853-1856), public outrage over the treatment of wounded British soldiers led the War Office to enlist the services of Florence Nightingale. Nightingale and her staff of volunteers focused on sanitation, ventilation and waste disposal. Because of her efforts, she “broke the monopoly of health care as the sole providence of the physician, which led to the development of the healthcare team in modern medical practice.” (Manring et al., 2009, pg. 2169)

Black and white photograph of four medical corps members transporting an injured soldier from battle.
Members of the Medical Corps removing the wounded from Vaux, France. Photo via National Archives

Military medicine faced its greatest challenge during the world wars and the field continued to shape itself into the modern version that is present today. When the U.S. joined World War I (1914-1918), hospitals, doctors, nurses and ambulances accompanied the soldiers and commanders. Ambulances were used to transport the wounded from the battlefield, and from there the soldiers would be taken to a healthcare team or moved to a facility where they could recover. (Van Way, 2016) Between the wars, medical advancements were incorporated in the field of military medicine such as “Blood and plasma transfusions, widespread use of intravenous fluids, antibiotics (but limited to penicillin and sulfonamides), endotracheal intubation, thoracic and vascular surgery, and the care of burn wounds.” (Van Way, 2016, pg. 338) 

Military medicine was further tested during conflicts such as the Korean War (1950-1953), the Vietnam War (1955-1975), the Gulf War (1990-1991) and the wars in Afghanistan (2001-2021) and Iraq (2003-2011). According to Manring et al’s 2009 historical review, “Trauma care for US soldiers in Iraq and Afghanistan currently is provided through five levels of care: Level I, front line first aid; Level II, FST (Forward Surgical Team); Level III, CSH, which is similar to civilian trauma centers; Level IV, surgical hospitals outside the combat zone…and Level V, major US military hospitals…” (Manring et al., 2009, pg. 2171)

Aerial photograph of set of military hospital tents in an open field.
Photo and caption via National Archives Catalog. Caption: An aerial view of a field hospital erected during Exercise WOUNDED EAGLE '83.

The path to our current military medicine field and system was windy. The field was influenced by scientific advances and historical figures such as Baron Dominique-Jean Larrey, Florence Nightingale, Dr. Walter Reed, Leonard Wood and thousands of physicians, surgeons, nurses, ambulance drivers and other professionals. If you are interested in hearing firsthand accounts from military healthcare professionals, visit the Library of Congress’ collection ‘Healing with Honor: Medical Personnel.’ The collection features personal narratives from people who served in conflicts such as World War I, the Korean War or the war in Afghanistan. ‘Healing with Honor: Medical Personnel’ is an excellent way to learn more about the field of military medicine and its commitment to the treatment of soldiers harmed during conflicts.

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Summer is the perfect time to catch on your yearly reading goals! Many local libraries hold summer reading events for adults and often offer prizes to reward participants for achieving their goal. With the warm weather and extra sunlight, summer is a great time to visit a park or the beach and spend some time reading your favorite novels or trying a new selection. Are you unsure of what books to pick up or what genres to explore this summer? The staff at Himmelfarb library offered some titles and authors that may be worth exploring! 

Systems Librarian JoLinda Thompson recommends Abraham Verghese’s latest novel The Covenant of Water. “I loved Cutting for Stone so I am anxious to read this one!” When asked if there were any genres she associates with summer, she said “I like reading a series or big, epic novels like the new Verghese book.” Himmelfarb Library recently acquired a copy of The Covenant of Water and it is now available for checkout! 

Metadata Specialist Brittany Smith also prefers to read series or epics during the summer. She suggests reading The Lord of the Rings trilogy by J.R.R. Tolkien, the Broken Earth trilogy by N.K. Jemisin or The Teixcalaan duology by Arkady Martine. If you want to add an extra layer of enjoyment to your Lord of the Rings reading experience, she suggests watching the movie after finishing the corresponding book in the series. Brittany also enjoys reading romance novels in the summer because they are typically light-hearted and can be read in a few days. 

Randy Plym, our new Evening & Weekend Supervisor, suggests books by David Mitchell. Specifically Ghostwritten or Number9Dream. “All of his books, but those in particular, are books that make me feel like the possibilities of life have opened up, which is a good feeling for summer.” 

Finally, Reference & Instructional Librarian Deborah Wassertzug says that James Hannaham is an author worth reading! She says that Hannaham’s latest novel Didn’t Nobody Give A – What Happened to Carlotta  “contributed to my understanding of the experience of transgender people and incarcerated/formerly incarcerated people.” 

Other recommendations from our staff members include The Autobiography of Malcolm X, Finding Me by Viola Davis, The Shack by William. Paul Young, Spoiled Brats by Simon Rich, The Hike by Drew Magary, and Assassination Vacation by Sarah Vowell! If any of these selections sound interesting to you or if you’d like to share your recommendations, please let us know in the comments! Or tag us on Facebook or Instagram and tell us what books you plan to read this summer!

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Photo Credit: Jason Henry via Heinz Awards

Dr. Abraham Verghese is a physician, best-selling author and professor of medicine at Stanford University of Medicine. Verghese is known for work with bedside medicine and the benefits of providing patients with physical examinations. In a 2011 TEDTalk, Verghese said “Too often these days, rounds look very much like this, where the discussion is taking place in a room far away from the patient. The discussion is all about images on the computer, data. The one critical piece missing is that of the patient.” (Verghese, 2011) Verghese is also known for his creative writing career and has published two nonfiction books and two fiction novels. He believes physicians should read more than scholarly or nonfiction texts, saying “I preach to my medical students that to fully imagine their patients’ lives they must read fiction, because fiction is the great lie that tells the truth (to paraphrase Camus).” (Clarke, 2023)

Dr. Abraham Verghese was born in 1955 in Addis Ababa, Ethiopia to two Indian parents. His parents worked as educators in Ethiopia and he first began his medical education in the country. In an article from the New York Times, Verghese credits W. Somerset Maugham’s book Of Human Bondage as influencing his decision to become a physician: 

“Somehow, when I read those words as an underachieving student in high school, it suggested to me that anyone with a curiosity and empathy for their fellow human beings and a willingness to work hard could be a good physician and be rewarded by work that has great meaning.” (Clarke, 2023)

Unfortunately, political unrest interrupted Verghese’ medical education. In the 1970s, the Ethiopian emperor and government were overthrown and a civil war broke out across the country. Verghese, along with his parents and siblings, left Ethiopia for the United States. While living in the U.S. Verghese worked as an orderly. He continued to pursue a career in medicine. He attended Madras Medical College in India and graduated in 1980. He pursued a residency program in Johnson City, Tennessee. In 1983, after completing his residency, he was selected for a fellowship at Boston College School of Medicine. During his time in Boston, he witnessed the HIV outbreak that hit urban areas such as Boston and other major cities. Verghese returned to Johnson City, Tennessee and once again was face to face with the impacts of HIV/AIDS, this time in a rural setting. 

When reflecting on that time, Verghese said “I first toyed with the idea of writing because I was so affected by what I witnessed as an infectious diseases specialist during the early years of the AIDS epidemic, taking care of dying men (mostly) who were my age.” (Clarke, 2023) He later wrote about his experiences in his first book My Own Country: A Doctor’s Story of A Town and Its People in the Age of AIDS.

Verghese took a break from practicing medicine and attended the Iowa Writers Workshop at the University of Iowa. He earned his Masters of Fine Arts in 1991. He served as a Professor of Medicine and Chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center. Then in 2007, Verghese moved from Texas to California to work as a professor at Stanford University School of Medicine, a position he still holds. 

Dr. Verghese also maintains a successful writing practice and career. Besides his first book, My Own Country, Verghese has also published The Tennis Partner: A Story of Friendship and Loss, Cutting for Stone and most recently The Covenant of Water which is an Oprah Book Club selection. The Covenant of Water has received high praise from reviewers. An NPR review stated “Ever the skillful surgeon, Verghese threads meaningful connections between macrocosmic and microcosmic details so elegantly that they are often barely noticeable at first.” (Bhatt, 2023) The reviewer also noted that “Whether describing the spice craze sweeping across Europe, Kerala’s breathtaking coastal views, the overpowering Madras evening breeze, or the lively Anglo-Indian enclaves, Verghese tends to be lyrical. But he writes with such singular detail and restrained precision that it is a pleasure to be swept along and immerse deeper.” (Bhatt, 2023) If you are interested in hearing Dr. Abraham Verghese speak or want to learn more about his latest release, please see this upcoming Politics and Prose event!

If you would like to learn about Dr. Verghese’s experiences as a physician or his clinical research interests, read his recent publications such as “Medicine is Not Gender-Neutral–She is Male,” “Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter” or watch his 2011 TEDTalk “A Doctor’s Touch.” 

Works Cited:

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Himmelfarb’s Diversity, Equity and Inclusion Committee (DEI Committee) is pleased to announce the release of the new Antiracism in Healthcare research guide! This guide is one of many ways Himmelfarb Library is showing its commitment to cultivating an inclusive and welcoming environment within the library. The guide features healthcare organizations, journal collections, virtual tutorials and more to help you learn about antiracism and racial biases in healthcare. Some of the resources listed include:

Please note that some of the resources, such as ebooks and journal collections, may require GW credentials to access. 

The DEI Committee envisions this guide growing over time and we are interested in community feedback and being transparent about the selection process. To show our commitment to community building and transparency, the resource selection criteria is featured on the guide’s homepage and the Committee will evaluate suggested resources based on the five listed categories and evaluation questions. Students, staff and faculty members are invited to submit resources they believe will make an excellent addition to the guide. If there is a book, documentary, podcast show/episode, online training, healthcare organization or other valuable resource that you believe should be included, please fill out the ‘Resource Suggestion Google Form’.

Additionally, if you are a member of a GWU organization and would like for your organization to be featured on the research guide or if you’re interested in partnering with the DEI Committee, please contact the current committee chair, Rachel Brill, at rgbrill@gwu.edu!

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Trans and gender diverse people often report encountering many barriers to care when seeking health care services. According to researchers, some of these barriers include trans and gender diverse people being uninsured/underinsured, patients having to teach their providers about transgender health, experiencing transphobic discrimination during healthcare visits, and a general lack of healthcare providers knowledgeable about transgender health (Safer et al., 2016; Warner & Mehta, 2021). Citing the 2015 United States Transgender Survey, Warner & Mehta write that “Among the conclusions provided, 33% of respondents seen by a healthcare provider within the year prior to completing the survey reported having at least one negative experience related to their gender identity” (Warner & Mehta, 2021, pg. 3359).

Providing a safe and nonjudgmental healthcare environment is necessary when interacting with any patient. Many trans and gender diverse people report that many of the solutions are relatively simple and will improve the quality of care for everyone. In an effort to continue the discussion on supporting the trans community, particularly in healthcare settings, this article will serve as a follow-up post to our recent article International Transgender Day of Visibility, and provides tips on how to interact with trans and gender diverse patients.

Tips:

  • Use a patient’s personal name and pronouns: A simple way to make trans and gender diverse patients comfortable is by using their personal name and pronouns. If you are unsure of how to refer to your patients, ask what their pronouns are and how they would like to be referred to. You can also offer your name and pronouns first and offer them the opportunity to share their information. In an article in Healthline, KB Brookins also suggests providers evaluate their intake forms and include information fields such as “Legal name for insurance, chosen name/nickname, sex assigned at birth (if necessary), sex listed on insurance, pronouns, gender identity, sexual orientation (if necessary)” (Brookins, 2022). Consider leaving open fields for people to write in their responses instead of checking off a set number of boxes. Using a person’s correct pronouns and name will build trust between patients and providers and this will encourage patients to return for future appointments. 
  • Do not ask personal questions not related to care: Trans and gender diverse people are subjected to frequent and invasive questioning about their bodies or any medical procedures they may have experienced. This form of questioning is deeply personal and can make trans and gender diverse people uncomfortable. Vermeir, Jackson & Marshall write “Many trans people encounter HCPs [healthcare providers] who ask inappropriate questions regarding their trans identity or bodies, or questions that are irrelevant to their care” (Vermeir, Jackson & Marshall, 2018, pg. 16). To avoid these uncomfortable situations, Vermeir et al. suggests that providers maintain professional boundaries and ask questions that are directly related to the reasons behind a patient’s current visit. “Participants recommended that HCPs remember that a patient’s purpose is not to satisfy one’s interest, and that even if a question is relevant to one’s care, it must be asked with sensitivity and appropriateness” (Vermeir, Jackson & Marshall, 2018, pg. 16). 
  • Learn more about the community from multiple perspectives: Understanding the transgender community allows providers to better understand their patients’ needs and provide a high standard of care. It may seem easy to ask your patients about the history and current state of the transgender community, but some trans and gender diverse people report that they feel burdened when placed in this position. There are organizations, novels, memoirs, historical accounts, and other resources that may serve as appropriate sources of information. Resources will be listed in the ‘Reference’ section. Here is a brief selection of titles:

These tips are just a starting point for treating transgender and gender diverse patients with respect and dignity. Vermeir, Jackson & Marshall also suggest that educational organizations broaden the scope of their curriculums to include transgender health and healthcare. The authors say “...we believe that there is also a need for education organizations and regulatory bodies to incorporate this topic into their curriculums and continuing education opportunities to promote HCPs’ cultural competence including an acknowledgment of the power differentials between HCPs and trans patients” (Vermeir, Jackson & Marshall, 2018, pg. 15). Ultimately, healthcare providers must listen to transgender and gender diverse patients and unlearn any biases they may have about the transgender community. By incorporating these and other tips into your practice, you will build trust with your trans and gender diverse patients making it easier to meet their healthcare needs.

References:

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