On Feburary 28th, the Medical Library Association announced that the 2008 Louise Darling Medal for Distinguished Achievement in Collection Development in the Health Sciences was to be awarded to the New York Academy of Medicine Library for its bimonthly publication, The Grey Literature Report. The product and the history behind its parent institution are examples of the best of traditions and the most far-seeing of re-inventions.
First, a few things about the New York Academy of Medicine. In one sense, it’s a legacy of the way men (and sorry to say, it was almost always exclusively men….even the New York Academy of Medicine that we honor here did not have its first female president, Mary Anne Payne, until 1987) of the sciences and medicine operated socially and professionally in the 1700s and 1800s. With either credentials or money, and usually both, those who shared an interest in science and/or medicine got together for both social and professional meetings, at which scientific papers or case studies were read by members before a live audience of their fellow members. In some cases, usually at specified annually recurring times of the year, the membership would gather together to hear a specially invited expert give an overview of their field from either their particular specialty (progress in gallbladders) or geographic perspective (surgery in Berlin) .
It was common for professors or physicians new to the community to present their inaugural papers so as to introduce themselves, demonstrate their expertise, and then to be formally received into the “company of men of medical science and letters.” Courtesy privileges of meeting attendance and facility use were often extended for limited times to members of similar academies from other countries or cities who were in town visiting.
It was also not unusual for members who were out of town on sabbaticals, expeditions, military service, or otherwise traveling abroad to have their letters of professional correspondence to their home academy read out aloud at meetings as well, if the medical news was particularly exciting. Such letters served not only to update the listeners in a brief manner, but also worked as placeholders for the upcoming weekly or monthly sessions, reserving that topic for their expertise, so as to avoid being scooped or superseded.
There were several other commonalities among these academies and societies.
First, they were almost always located in major cities with populations in the hundreds of thousands, where concentrations of educated men of science and medicine were sufficiently great to keep up regular meetings, and where there were enough lay people who could afford to pay for medical services for the academy’s members to be able themselves to afford to support financially the dues or membership entry fees, which were often quite steep (presumably to keep out the riff-raff, even if they had some sort of credentials .)
Yet, in their own way, these academies were more an oligarchy of the moneyed meritorious than of the sometime eccentrically chosen nobility of only those experts the king or emperor deigned for whatever reason to become members of this or that Royal Academy. While an initial attempt at entry might well be blocked unfairly by religious, racial or ethnic bigotry, or lack of “social standing” for a given physician , undeniable success in treating patients, and in uncovering new discoveries or pioneering new procedures tended to open wide the doors sooner or later. (Abraham Jacobi, often described as the founder of pediatric medicine in America, was a German Jewish immigrant. He was elected president of the New York Academy of Medicine in 1885…..it is not clear that this would have happened in other elite membership institutions at that time).
Second, the city or the nearby region had to be sufficiently large to support a fairly large number of hospitals and institutions of higher learning, not just one or two. While an ever-increasing proportion of the membership were medical school or university graduates, they tended not to be graduates of the same school or even all attending physicians at the same hospital. The academies were not alumni or faculty or professional staff organizations, because even then it was recognized that medicine in the city would not flourish without competition among those who had differing school ties, and without the back-and-forth flow of new ideas , and without the infusion of fresh blood (and sometimes the new money) through the arrival of new graduates or the influx of new practitioners from other cities.
Ultimately, the academies encouraged a sense of devotion , fraternity, respect and advocacy within and for medicine and surgery as a calling or profession. They sought to become, and indeed often became the collective voice of reason, authority, and expertise in medicine within their city. That this was often a success in the past can be demonstrated in the deference of city fathers to their city academy’s advice (fluoridation in NYC was spearheaded by eventual NYAM President Duncan W. Clark) , as well as by the legacies left to the academies by their late members and by city philanthropists, who supported them much as they might art museums , concert halls, churches, and the hospitals themselves.
Third, these societies and academies almost always bought or built themselves a fairly impressive headquarters building. These were deliberately designed to be the equivalent of the gentlemen’s club where the wealthy could dine in comfort, attend the meetings in a fine lecture hall or amphitheater, as well as venture into the marble-floored, wood-paneled , and well-stocked library and read not only their own academy’s minutes, but those of their peers in other cities, for by the late 1800s, many of these societies had turned their privately issued “Proceedings” into the progenitors of today’s medical and scientific journals. Indeed it is essentially from the oral traditions of the academy’s meetings and public issuances that we have the six part hierarchy of types of journal articles we see today: regular articles of laboratory or clinical investigations, case studies, letters to the editor, meetings abstracts, invited expert reviews, and consensus statements.
But today, while city medical academies and societies still exist, they are almost always an organization with little more than office space, whose members are more likely to meet once or twice a year in a hotel ballroom, or at a restaurant. Doctors today are far more likely to go to the conventions of their particular medical board specialty in a distant city, than to meet locally. In many cases, if the buildings are still standing, the academy’s old headquarters are now in fact, restaurants , urban private social clubs, or condos. Their collections have been dispersed to the nearest medical schools, and their journals are now defunct. In a sense, what they did for medicine has now been usurped by expanded facilities at medical schools and teaching hospitals, and by national medical society, board specialty, and for-profit publishers. The academies had become, in many cases, irrelevant to the profession and the cities they once served.
But the New York Academy of Medicine is very different. It still has a fine building, with a stunning rare book room and a collection of over 800,000 print volumes. It looks like a well-endowed museum in some respects, but it is certainly not just that. It’s a lot more.
How did they do it? The answer is that NYAM concentrated on the best parts of their historical legacy as a place for exchange of new ideas, of medical advocacy for the city , and for recognition of merit, while actualizing the talent and genius of being in New York City and doing those things that matter to the world of medicine that no one else had thought of doing before , or doing what those characteristically modest New Yorkers simply thought they could do better than anyone else.
Without themselves becoming a medical school they became a center for advocacy, expertise and continuing training in vital areas like Aging Populations, Consumer Health Information, Crisis Management, Drug Addictions, Ethics, Environmental Impacts, Health Disparities by Ethnicity and Social Class , Disparities in Attitudes concerning, and Treatments for those with Mental Illness, the Professionalization of Medical Social Workers. Urban Asthma, Hepatitis C, HIV/AIDS, Terrorism & PTSD, and on, and on. While other journals based at academies have faded, the NYAM’s Journal of Urban Health continues to be vital.
This is not to say that all the members currently work in NYC, or even grew up there. Rather, the place has become a center that recognizes achievement and talent and confers Fellowships on frankly what could be best described as the “very deserving,” for their contributions to medical education or research, or (and some things never change because it would be unwise to do so), for their unstinting philanthropy and financial expertise in the service of these good causes.
The NYAM library is expert in both the past (it has an incredible rare books collection and preservation program) and the present (it is the home of the National Online Training Center) teaching searching skills to librarians and healthcare professionals.
But most pertinently in the case of this most recent mark of distinction, the academy alertly recognized that someone ought to be keeping track of some of the major policy guidelines, state commission reports, statistical tables, advocacy group studies, and other materials that appear neither in regular journal articles, nor in “regular books.” This is what physicists and engineers have long called grey literature (in part because it was not always official, or in black-and-white, hence the title The Grey Literature Report.
What will you find? In the most recent issue:
· The AARP’s report on access, satisfaction, and costs associated with prescription drugs and Medicare Part D.
· The Access Project’s report on health insurance for farm and ranch operators
· AHRQ’s latest study on Methicillin-resistant staph infections in US hospitals.
· The Association of American Medical College’s study on the medical school’s role in the treatment of overweight and obesity.
And that was just a part of the entries under the letter A….there’s also a a Harvard University report from the John F. Kennedy School of Government on the long term effects of mosquito eradication in India….How many of us would have known to check up the publications of the JFK School for a report on malaria?
And for this “still-new-to-Arkansas” librarian, there is an incredibly documented, statistically rich study from the Southern Institute on Children and Families on uninsured children in the South…..
So check out the Grey Literature Report, and find out why the Medical Library Association chose so well this year in their honoree. The answer is that the NYAM could have relegated itself to being a dinosaur in a museum, but they became instead the T. Rex of reinvention.
Tony Stankus firstname.lastname@example.org Life Sciences Librarian
University of Arkansas Libraries MULN 223 E
365 North MicIroy Avenue