National Nurses United

nurses all smoked in their attempts to connect with psychiatry patients, control their behaviors, or cure their illnesses. Psychiatrists further perceived cigarettes as highly effective in dealing with patients' problematic behaviors and were assumed to be less poten- tially harmful than conventional medications. Cigarettes were so important that "some hospitals of the states grew and supplied tobacco to the patients, and a tobacco allotment was widely included as part of the patients' basic board," writes Hirshbein. At the same time, mental health providers needed to balance the desires of patients to smoke and their doctors' often permissive poli- cies letting them do so with the potential physical dangers of smok- ing, and this responsibility often fell on the shoulders of nurses who managed the day-to-day operations of mental hospitals. Hirshbein writes that power struggles between the nurse-doctor relationship often played out over smoking. "In textbooks, educators warned nurses to be ever vigilant about the potential safety risks in smoking, particularly when patients were brought cigarettes, lighters, and matches by visitors," Hirshbein writes. "Nurses expressed discomfort over the conflict between their mission of allowing patient autono- my and their professional ethos of helping patients. One troubled nurse gave an example of dealing with a patient who kept burning her fingers because she would fall asleep with a lit cigarette. What should have been done when the rules were that the patients should not be denied her cigarettes, but the nurses did not want to neglect her physical well-being and allow her to get hurt?" Smoking privileges were also sexist, Hirshbein pointed out. Male patients were given more freedom to smoke than women. Smoking habits among women were associated with psychiatric behaviors while men who smoked were assumed normal. The two seminal moments in perceptions of smoking came in 1964 and in 1988 when the United States surgeon general issued reports that, respectively, stated cigarette smoking caused cancer and other health problems and that people continued to smoke despite health risks because nicotine was addictive. One result of these revelations was that the tobacco industry, eager to protect and grow its consumer base, started conducting in-depth and STIFFS, SKULLS, & SKELETONS: Medical Photography and Symbolism By stanley Burns, Md and elizabeth a. Burns schiffer Publising, 2015 What at first glance looks like a gigantic and unusual cof- fee table book (the cover depicts a number of mummified bodies and skeletons presiding over a sleeping man on an examination table) houses an astonishing historical collection of photographs showing the use of anatomical props from the first century of photography. Photo after photo shows people, usually medical students and doctors, posing with dead bod- ies or body parts. the photographs come from the collection of stanley B. Burns, Md, who is widely regarded to own one of the most important private collections of early vernacular photography covering the period from 1840 to 1950. the Burns Collection consists of more than one million photographs, and Burns has published more than 43 photographic historical books. this particular book builds on an earlier book of medical photog- raphy that included medical, crime scene, and post-mortem photos. this one expands "the visual history of the body to include all the major significant photographic subjects, includ- ing images of scientists, artists, and the public, as well as pho- tographs of physicians who used skulls or a cadaver for documentation of the profession," writes Burns. Stiffs, Skulls, and Skeletons is organized into chapters that include "Posing with skulls and bones," "dissection photogra- phy," "autopsy and forensic photography," and "X-rays—the skeleton becomes visible in the living," among others. in the vast majority of these photographs, women are missing, and the only living people shown are mustachioed young, male medical students posing with their cadavers. the book also has its fair share of photographs showing medical deformities: patients suf- fering from rickets, genetic conditions, missing bones, amputations and extreme surgeries. Burns writes that in an age where death was much more common and the lives of people considered "other"—criminals, ethnic minorities, people born with congenital birth defects—were not valued, there was no attempt to protect the identity of the photographic subject. Most of the photos show the face of the subject and the photographer made no effort to cover pri- vate parts for modesty. it's a fascinating book to flip through and read. any student of history or photography might well become engrossed in the hundreds of photos displayed. —lucia Hwang j u ly | a u g u s t 2 0 1 5 w w w . n a t i o n a l n u r s e s u n i t e d . o r g n a t i o n a l n u r s e 17

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