Monday, May 20, 2019

Miss Charlton, Miss Noyes, Dr. Osler and the Founding of the Medical Library Association

Miss Charlton, Miss Noyes, Dr. Osler and
 the Founding of the Medical Library Association
A Presentation to the 2019 American Osler Society Conference

In 1896, Dr. William Osler was elected president of the Medical & Chirurgical Faculty, and as he often did, he came in like a whirlwind. A building, which was slated to be the long-term home of the Faculty, was purchased. A new library was opened with much fanfare. The Book & Journal Club was established, and everyone clamored to join. All looked rosy on the surface.

But the Faculty’s library had actually fallen on hard times after the Civil War, Maryland being a border state, and was struggling to recover. The collection had moved several times, becoming less and less organized. There was no librarian for much of this time, and physicians could “buy” a key to access the library. There was room for a library in the new building, but the outdated collection of books assembled over the past six decades was mostly in boxes, and the newly-hired librarian wasn’t up to the job of bringing order to the collection.

Dr. Osler quickly raised funds to create a cozy and fraternal reading room, where physicians could gather and talk about books. His next mission was to find a librarian who could manage both the collection of books and the membership of the Faculty.

After consulting the president of Baltimore’s Enoch Pratt Free Library, Dr. Osler hired a young librarian, Miss Marcia Crocker Noyes. Less than two weeks after her interview with Dr. Osler, she went from living with her sister and being the head of circulation  at the Pratt library, to living at the Faculty’s building and becoming its sole employee.

While her background was in the nascent field of library studies, she had absolutely no medical experience. But that was something which Dr. Osler thought could be easily remedied. She made herself invaluable to the physicians at the Faculty and was at their beck and call, literally 24-hours a day.

As part of her job – and much of it was “other duties as specified” – she made herself available to other medical societies to assist them in creating their medical libraries, and began a system of exchanging duplicate books.
Among her early projects was culling the Faculty’s collection of books, keeping only the most current, and ones which hadn’t been damaged during the numerous moves.

Additionally, the card catalogue, which was outdated in myriad ways, was thrown out, and a new classification system of indexing and cataloging the books was established. As an aside, we still have the complete card catalogue, including cards written in Miss Noyes’s “library hand”, the standard for librarians before typewriters became popular.

While Miss Noyes was learning her craft at the Faculty, Miss Margaret Charlton, the Librarian of the Medical Department at McGill University, suggested an association of medical librarians. Although the American Library Association already existed, she noted that, “their problems are not our problems.”

The inaugural meeting took place in Philadelphia in May of 1898 with four physicians and four librarians, including Miss Charlton. Although Dr. Osler could not attend, he was supportive of the efforts, and paid for Miss Noyes and Miss Elizabeth Thies, the librarian from Johns Hopkins, to attend the meeting.

Miss Noyes and Miss Charlton would go on to excel in their field as librarians overseeing large collections, Miss Charlton at McGill and then Toronto, and Miss Noyes at the Faculty. Miss Thies left Johns Hopkins in 1899 to become the private librarian of Dr. Howard Kelly, one of the “big four” at Johns Hopkins. However, she was a charter member of the Medical Library Association and was elected to an honorary membership in 1948.

Among the earliest objectives of the MLA were: exchanging library duplicates; securing the libraries of retired or deceased physicians; distributing journals of various medical societies; and searching auction sales for antiquarian books.

From the first meetings, it was established that the organization was to be of and for medical libraries, rather than for librarians. The two main projects of the early MLA were a publication and the book exchange. Dr. Osler and Miss Noyes were integral to both in the MLA’s formative years.

Over its first decade and a half, the Bulletin (which we will use as an encompassing term for the MLA’s publications) was published in fits and starts. It was slated to be a quarterly publication, but that didn’t always happen.

The first publication was called Medical Libraries, published from 1898 to 1902, with the ambitious tagline from Oliver Wendell Holmes, “Libraries are the standing armies of civilization.” It was followed by the Bulletin of the Association of Medical Librarians, which only lasted a year. Miss Noyes, along with Dr. Henry Hurd of Johns Hopkins and Mr. John Brownne of New York, edited the publication.

Up next was the Medical Library and Historical Journal, which lasted from 1903 to 1907. These volumes were filled with original articles and tips for caring for a library, including hints on dealing with broken bindings, bugs, dust and mis-filed books.

Finally, came the Aesculapian, which lasted three volumes. Publications ceased for the next four years.

In 1911, the publication was revitalized, and became The Bulletin of the Medical Library Association. This continued to be its name until 2001, when it was renamed The Journal of the Medical Library Association.

The Bulletin moved into the Faculty’s building and Miss Noyes, and her close friend, Dr. John Ruhräh became the editors. The first volume of the new Bulletin contained a history of the Association, basically bringing everyone up to date on what had happened over the past few years. She continued as editor, with various collaborators, until 1926.

While the Exchange and the Bulletin were suffering a tumultuous first decade, the organization managed to have annual meetings, the first two in Philadelphia, then Atlantic City, Baltimore, Chicago, Boston, St. Louis and others. It was at the 1901 meeting that Dr. Osler was elected as President of the organization. He stepped down in 1904, most likely due to his incredible non-stop schedule of teaching, writing and travelling, but perhaps due to the idea of an upcoming possible appointment as Regius Professor at Oxford.

The Exchange was the other original mandate of the organization. Dr. Osler was a huge bibliophile and was exceedingly generous in giving libraries the rare books and journals that he found in his travels. He wanted every library to be great.

During its first year, the Exchange was in Philadelphia. It then moved to Baltimore where Miss Noyes oversaw it, helped by a part-time employee, from 1900 to 1904. To give you an idea of the numbers involved in the Exchange, in 1901, 2,443 books were distributed, and 2,126 books were received. Even today with computers and spreadsheets, this would be a daunting job!

Dr. Osler had established the Book & Journal Club, and it was one of the Faculty’s most popular clubs. Of course, Dr. Osler had an ulterior motive in establishing this club – if physicians knew about the Faculty’s library, they would be more likely to support by donating their book collections to it and perhaps to the MLA’s Exchange.

To give you a quick idea of the quality of the Book & Journal Club, at one meeting, Dr. Harvey Cushing shared a notable collection of the works of Vesalius, partly from his own library, and partly from the libraries of Dr. Howard Kelly and Dr. Osler. This included three copies of the first edition of De Humani Corporis Fabrica from 1543, as well as others rare volumes on anatomy.

When the Faculty celebrated its centennial anniversary in 1899, it was an occasion for gifts of rare books and fine portraits to be given to the Faculty, often with a slight push from Dr. Osler. And if there were duplicate volumes, all the better!

During the four years the Exchange moved away from Baltimore, the MLA realized exactly how much Miss Noyes did to keep it up and running in an orderly fashion. It was also during that period that Dr. Osler was President of the MLA and realized how important it was to keep the Exchange as THE integral part of the MLA. While the Bulletin was not being published, the Exchange was the glue holding the organization together.

By 1909, the Faculty had built its own building, and space for the Exchange was included in the plans. Dr. Osler had moved to Oxford in 1905 and Dr. John Ruhräh became the head of the Faculty’s Library Committee and was also active in the MLA as Treasurer. Dr. Ruhräh and Miss Noyes jointly edited the Bulletin from 1911 until 1926.

In some ways, Dr. Ruhräh took over where Dr. Osler left off. Both Miss Noyes and Dr. Ruhräh had a deep admiration of Dr. Osler, and remained friends with him until his death, 100 years ago this coming December. Dr. Ruhräh had attended Dr. Osler’s open clinics while he was in medical school (not at Hopkins).

The three seemed to have a similar sense of humor, and notes still exist of them teasing each other. Dr. Osler sent Miss Noyes bouquets for her birthday, even though it wasn’t her birthday. Dr. Ruhräh wrote a prescription to Miss Noyes on New Years’ Eve for a year filled with happiness and joy. Warm letters were sent back and forth across the Atlantic. The affection between these friends is apparent all these years later.

As he was dying, Dr. Ruhräh wrote his recollections of his years as a student of Dr. Osler’s. They also shared a mutual love of books – the rarer the better. Several years ago, we discovered the unpublished manuscript, dusted it off and published it. Dr. Ruhräh’s personal anecdotes cement the memories of Dr. Osler’s years in Baltimore.

In the decade and a half after the Bulletin and the Exchange moved to Baltimore, both continued to grow and prosper. Miss Noyes eventually hired a second assistant to help with the Exchange, and things carried on until eventually, it all just became too much.

But by 1926, the strain on the resources and staff at the Faculty became overwhelming, as they were essentially not paid to run the Exchange. It was difficult for member libraries to understand that just because they wanted a volume, it wasn’t always available, despite the huge number of books flowing in and out of the Exchange. This was a source of frustration to Miss Noyes and she writes about it in the Bulletin as she is stepping down from running the Exchange.

In the 20’s and 30’s, Miss Noyes was the Executive Secretary of the Faculty, and lived and worked on the premises. She was also the Faculty’s Librarian, on call 24/7. For part of that time, she was the editor of the Bulletin and was managing the Exchange, which was receiving and distributing more than 20,000 volumes a year.

She worked with medical societies across the country to help them establish their libraries, and was an active member of the MLA.

In 1934, she became the first woman, and the first person with a non-medical background, to become President of the MLA. She finally incorporated the organization after almost 40 years, and constantly travelled to visit member libraries across the country. And now, she was ready to slow down a bit.

Miss Noyes remained an active member of the MLA and attended conferences and meetings. Letters between Miss Noyes and Dr. William “Billy” Francis, Osler’s nephew and the head of the Osler Library at McGill, indicates that sometimes they were happy with the MLA and sometimes it really irritated them and they didn’t agree with the way it was being managed.

Miss Noyes died in 1946, 50 years after she had first arrived at the Faculty. Her funeral was held in Osler Hall, named for her dear friend. More than 60 physicians whom she’d served acted as the pall-bearers.

Former Faculty President and friend, Dr. Albert Chatard wrote this in her obituary in the MLA Bulletin:
Miss Noyes created a created a reality of the hopes and dreams Dr. Osler formulated while he was at Hopkins… On this foundation, she worked constantly, before and after he left Baltimore, as his understudy to create an atmosphere both effective and genial, so that people would like to come to the building… and would feel that interesting and important things were going on under its roof.

On a related note, last week was the Annual Conference of the MLA and the Marcia C. Noyes Award which recognizes a career that has resulted in lasting and outstanding contributions to medical librarianship, was given to MedChi’s friend, MJ Tooey. She is the Executive Director of the Health Sciences and Human Services Library at the University of Maryland in Baltimore.

We continued the tradition of giving flowers, started by Dr. Osler, and presented a bouquet in Miss Noyes’s memory, with all of our love.

Presentation by Meg Fairfax Fielding
2019 American Osler Society Conference
Montreal, Quebec, Canada
May 13-15, 2019

Tuesday, May 7, 2019

2019 Noyes Award Winner: MJ Tooey

The 2019 Marcia C. Noyes Award, given by the Medical Library Association, has a special meaning this year, both professionally to our organization and personally to me, your blog author. 

Not only is it the 100th Anniversary of the death of MLA founder, Sir William Osler, MD, but the winner of the award is MedChi friend, MJ Tooey, AVP Academic Affairs, and Executive Director of the Health Sciences & Human Services Library at the University of Maryland, Baltimore. 
MJ has been more than kind in assisting MedChi and the Center for a Healthy Maryland on more than one occasion.
She participated as a guest lecturer a few years ago when we presented a talk on three aspects of Marcia Noyes's life - the academic, the ethereal and the artistic. 

The links between MedChi go back more than 200 years, when the Medical & Chirurgical Faculty of Maryland founded the first medical school in Maryland. Marcia Noyes, MedChi's librarian for 50 years, was instrumental, along with Dr. Osler, in founding the Medical Library Association, about which I will be lecturing at McGill University next week.* The Noyes Award was established in 1947, just after Marcia's death, and is only awarded to exceptional librarians, not annually.

There are many accounts of the physicians at MedChi, or the Faculty, as it was known then, giving bouquets of flowers to Marcia. About five years ago, we decided to revive the tradition and give the winner of the Noyes Award a bouquet of flowers, with Marcia's approval!

The Noyes Award is being given to MJ Tooey this week, pulling together some of the strands of the history of several organizations where both Sir William Osler, MD, and his favorite librarian, Miss Marcia C. Noyes, were both intimately involved. (The actual awards ceremony is at the finale of the conference, but the winner gets the flowers at the opening breakfast so they can enjoy them throughout the conference week.)
Like Marcia, MJ is exemplary in her field and is such a deserving recipient of the Marcia C. Noyes Award. From all of us at MedChi, our warmest congratulations go to our friend, MJ Tooey. 

*Look for my presentation about Marcia, Osler and the founding of the MLA on this blog in a few weeks.

Thursday, May 2, 2019

2019 Hunt History of Maryland Medicine Lecture

The Center for a Healthy Maryland is pleased to announce that this year’s speaker for the Thomas E. Hunt, Jr., MD History of Maryland Medicine will be Dean Paul Rothman, MD, Chief of the Medical Faculty at Johns Hopkins Medical System.
In this centennial anniversary of Sir William’s death, Dean Rothman’s lecture will discuss how Osler’s influence has spanned the century, with original ideas from the late 1800’s coming full circle and being used in the practice of medicine today.
As Dean and CEO, Dr. Rothman oversees both the School of Medicine and the Johns Hopkins Health, which encompasses six hospitals, a self-funded health plan and hundreds of community physicians.
This year’s lecture will take place on Thursday, June 6, 2019 in MedChi’s Historic Osler Hall. The evening will begin with a reception at 6:00 and the lecture at 6:30 p.m. RSVP HERE by June 1, 2019.