Tag: casenotes

Archives

The Neurosurgical Case Notes of Sir Geoffrey Jefferson

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By Karen Rushton, Wellcome Archivist/Curator, University Archive & Records Centre, The University of Manchester (Karen.rushton@manchester.ac.uk)

 

At the University of Manchester thanks to a generous Wellcome Trust grant we are currently working to catalogue the case files of 20th century neurosurgeon Sir Geoffrey Jefferson (1886-1961). Jefferson was the UK’s first Professor of Neurosurgery who spent most of his career at the Manchester Royal Infirmary (MRI).

 

The case files we hold cover Jefferson’s time working at the MRI between 1927-1940 on a wide range of neurological disorders including brain tumours, epilepsies, neuralgias, head injuries, and congenital spinal deformities. We also see references to lingering war injuries from WWI, occupational and traffic accidents, neurosyphilis, and the use of surgical and diagnostic techniques later considered to be controversial. The files themselves contain a number of record types including detailed case notes and accounts of surgery, correspondence, x-rays, and both clinical and pathological photographs.

Neurosurgery lecture, with Sir Geoffrey Jefferson on the back row second from the left & Norman Dott on the second row from the back on the left, n.d. ref: JEF/1/10/3

 

Going into the project the first major decision centred on what information we wished to record. The Lothian Health Services Archive in Edinburgh have recently completed a similar project centred on the case files of neurosurgeon Norman Dott (1897-1973) and so it was very helpful to be able to talk to staff there about their approach to the records. Most importantly we recognised that the Jefferson collection is one of a number of neurosurgery collections held across the country and it was important to recognise its part in a wider research web and so make our catalogue comparable to that of the Dott Collection.

 

When dealing with relatively modern patient records considerations surrounding data protection were paramount and procedures are in place to produce a public facing catalogue with all personal information removed and a complete catalogue for use in-house and to be accessed by approved researchers. MeSH has been employed throughout for indexing purposes and provides an invaluable tool for selecting files based on conditions and symptoms. It is here where expert advice from a neurologist based within the University has aided us in creating accurate indexing terms and updating old-fashioned terminology. However, the major barrier with MeSH has arisen regarding the potential indexing of surgical procedures. As a neurosurgeon rather than a neurologist the procedures that Jefferson performed were seen as being a very important factor in the descriptive content of the catalogue, but whether or not it was appropriate to index them or not was another matter. As a thesaurus of modern medical terminology MeSH essentially is not fit for this purpose. Whilst old-fashioned terms for conditions can be updated there is no appropriate terminology for now obsolete surgical procedures such as the frontal lobectomy.

 

Having worked on other medical case note projects in the past, namely the Stannington Project at Northumberland Archives dealing with children’s TB files, I was well prepared for the kinds of challenges we might encounter. Nonetheless there is an inevitable variation in the content of the records and in turn the approach to outreach activities and potential researchers. As all the Stannington files related exclusively to children many of the former patients were still alive meaning we were fortunate enough to be able to interact directly with subjects of the records. Equally the subject of TB feeds very well into existing narratives on public health and has many links to social history. Neurosurgery on the other hand is much less overtly approachable to those with a non-scientific or medical background and it is here where interpretative events and blogs have been essential in drawing out less obvious themes and material such as the possibility of the use of visual material in the files by artists working in the medical humanities.

 

Illustration of a brain aneurysm by Dorothy Davison, c.1940s, ref: uncatalogued

 

The cataloguing process is nearing completion but conservation and outreach work will be on-going as the project continues. As part of the Wellcome funding we will also be tackling several other medical collections including the work of 20th century medical illustrator Dorothy Davison, medical artwork from the teaching collections of 19th century obstetrician Thomas Radford, and papers relating to the pioneer of the artificial hip Sir John Charnley.

News

Upcoming event: ‘Cracking the case note conundrum’ – Lothian Health Services Archive, Edinburgh, Wednesday 19th October 2016

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LHSA holds over one million patient case notes covering a wide variety of medical specialties. These folder-based case notes contain a range of documents relating to patient care, and can be a rich primary archival source for an array of historical, scientific and medical disciplines. Cataloguing such records, however, can be a difficult undertaking.

As part of the Centre for Research Collections’ exhibition Enhance, Access and Understand: The University of Edinburgh and the Wellcome Trust, archivist Louise Williams will explore how LHSA has overcome the challenges involved in cataloguing neurosurgical and tuberculosis case notes to realise the unique research potential of these two significant collections. This talk will take place on Wednesday 19 October from 12.30pm to 1pm, at the Centre for Research Collections, University of Edinburgh.

This event is free but places are limited – please visit the event page to sign up.

Meetings

Hosting HARG

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By Ruth Honeybone, Manager of the Lothian Health Archives

LHSA has been a member of the Health Archives and Records Group (HARG) for a long while, and today is the second time in five years that we’ve hosted their AGM. HARG is a group of archivists and records managers with responsibility for health records across the UK that come together a couple of times a year (usually once in London and once somewhere else!) to discuss shared issues and brief each other on changes in legislation and how they will impact on the records in our care. The membership is a bit wider than that though – anyone with an interest in health records and the history of medicine is welcome to join.

We were pleased to invite the group to the Centre for Research Collections for their ‘somewhere else’ meeting this year, and spent a really interesting and informative day with fellow professionals. Much of the discussion was around HARG’s brand new website: how we would like the site to look and what information we want to include to benefit those using it as much as possible (https://healtharchives.co.uk/). But it was also a chance to catch-up on others’ news and developments as well as share our own.

The afternoon concentrated on the Scottish perspective, and the group of us who look after NHS records in Scotland were able to introduce some of our work to ensure compliance with the Public Records (Scotland) Act and a conference we hope to run next year focusing on how NHS archives have been used in artwork and installations in Scottish hospitals to help patients and staff. Our Project Cataloguing Archivist, Aline, also talked about our case note cataloguing projects and there was time for those attending to take a behind the scenes tour and to have a look at our two current exhibitions, both of which draw heavily on the history of health and medicine (see our blog from 19 August for more info if you’d like to see them).

What kind of hosts would we be if we hadn’t made time for some lunch…?

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[This post originally appeared on the Lothian Health Services Archive blog, on 23 September 2016, http://lhsa.blogspot.co.uk/2016/09/hosting-harg.html]