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Displaying Content and Making Connections: Engaging Public Audiences through a Poster Exhibit on the History of Tuberculosis in Virginia

On September 18, 1893, Miss Ada V. Crump of Alexandria, Virginia, died at her home “after a long illness of consumption,” according to an obituary published in the local newspaper. Crump was a public school teacher for several years, but had to give up her position ‘when failing health compelled her to do so.’ ” The obituary in the Alexandria Gazette finished with this statement about the effects of this loss on the community: “She was a young lady deservedly popular, and her many friends will be grieved to learn of her death.”

Crump was just one of approximately three thousand Virginians and one hundred thousand Americans who died of tuberculosis annually in this era. The single greatest cause of death, according to census reports, consumption was widely perceived to be a “dreaded disease,” with a likely outcome of slow death for most victims. Yet this young woman’s life was more than just a statistic. At the time of her death, in late 1893, both health policy experts and medical researchers were increasingly optimistic about finding ways to prevent and even cure this disease. In addition, this obituary reveals that death from consumption was part of a larger story of lives lived “in the shadow of death,” to use the evocative title of Sheila Rothman’s major study of this disease, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Johns Hopkins University Press, 1995).

While Ada Crump may have been just one of thousands of victims of tuberculosis, her story can be recovered because it was recorded in an obituary published at the time in the Alexandria Gazette and now available digitally through the Library of Congress’s Chronicling America collection. Undergraduate students at Virginia Tech recently completed a research project in which they identified approximately one thousand Virginians whose deaths from consumption were reported in Virginia newspapers from the 1860s to the early 1920s. These personal narratives then became the basis for designing a poster exhibit exploring the history of tuberculosis which has been displayed in museums, medical libraries, public libraries, and university libraries in Virginia. The goal of the exhibit is to engage a public audience in understanding the historical significance of this disease while also illustrating important developments in medical understanding, cultural norms, and social experience.

The students began their research by identifying victims of consumption reported in Virginia newspapers available from Chronicling America. These titles include newspapers from major cities (Richmond, Alexandria, and Roanoke) as well as weekly newspapers from rural communities in the Blue Ridge Mountains, the Eastern Shore, and Shenandoah Valley. The proximity search allowed researchers to locate articles that have the two terms, “died” and “consumption,” within fifty words of each other. The students then entered all of the available information about each victim into a database. The approximately one thousand individual victims provide a rich record of the effects of tuberculosis on American society, on families, and especially on individuals.

During the course of this research on individual victims, the students identified themes that illustrated both the broader significance of tuberculosis in this historical context and provided a more textured understanding of the lives (and deaths) of these individuals.

The themes explored in the twelve posters included medical research on the disease, data about victims, public health measures, recommended cures, advertisements, and the significance of race. Each poster included individual examples of Virginians who died of consumption as a way to document the impact of this disease on society and on families during this era.

The posters used source materials as illustrations of the main themes. The photograph used to design the top banner for all the posters came from the Virginia Department of Health Annual Report, and showed patients at the Catawba Sanatorium, the first state institution in Virginia for tuberculosis victims. Other photographs from this report, as well as from an earlier issue of Virginia Public Health Reports, were used to illustrate open air cures and the Catawba Sanatorium. These reports also furnished several line drawings that were used to illustrate public health campaigns. The illustrations also worked well on the posters for the same reason that they were designed for use in the early 1900s: sharp images with a clear message. Newspapers provided illustrations for the posters on advertising and specifically on William Radam’s 1890 Microbes and the Microbe Killer in ways that exemplified how vivid images were paired with compelling personal narratives to sell cures to a desperate population. It was challenging to find clear reproductions, given the transition from print to microfilm to digitized scans, yet the project team was able to find effective images that also reproduced well. The popular response to scientific research on microbes was easily illustrated with headlines from Virginia newspapers as well as texts from medical journals published in Richmond. These sources combined to demonstrate two important aspects of the medical history of tuberculosis: first, the intense popular interest in promised cures for this disease, and second, the deep skepticism among doctors about exaggerated claims and extravagant promises. One poster is designed and written for children with the goal of explaining this disease in age-appropriate ways, focusing on ways to stop the spread of disease that would be most familiar to children. Finally, posters used charts from contemporary sources as well as a table created from the data collected and analyzed by the students to show, respectively, the age distribution of victims, as documented by the US Census, and the length of illness, as reported in the obituaries. The goal with all these illustrations was to provide compelling, accessible information that reinforced the textual analysis.

The process of creating the posters revealed a number of important steps. First, it was important to identify the research contribution of this project: what new information was being obtained, presented, and analyzed? As the students realized, the pairing of individual stories with broad thematic analysis was a way to make an original research contribution as well as an engaging public exhibit. Experts in visual design were consulted; multiple formats, backgrounds, and design elements were reviewed, and numerous opportunities were explored. While most of the designing was done in electronic form, using a laptop to project full-size images on a screen, at crucial points in the project more tangible formats were used, including writing on white boards at full scale. By printing the posters at full-size, the project team was able to determine which images were suitable to include on the posters. The project team came to appreciate the value of a form of peer review, as the posters were examined by individuals outside the project team. At a stage just slightly before the final printing, all the posters were printed on regular paper, taped together to be full-size, and put on the walls of the history department, with a note inviting comments, suggestions, and corrections. After one week, the project team reviewed all the comments, which included specific suggestions about format, spelling and syntactical corrections , and finally more substantive recommendations about content. While seeing criticism is rarely pleasant, the project team agreed that this external perspective was necessary before finalizing the posters for public display. The content that the students developed while preparing the poster exhibit included substantial documentation of the lives of individuals, but also providedbetter understanding of the social significance of this disease in a regional setting. The connections that the students made during their semester were not only the substantial research connections between medical discovery, public health, commercial exploitation, and personal narratives, but also the experience of working as a team on a collaborative project. They were the recipients of valuable advice and feedback provided by historians, data scientists, librarians, and science museum staff. This project effectively demonstrates how the medium of a poster exhibit allows student researchers to pursue depth (content) as well as breadth (connections). During a review of the steps taken to prepare the posters, one student offered the following summary of the value of this experience: “Creating posters makes you think about what you are learning.” This statement, as much as the posters themselves, represents the most promising evidence of the value of involving students in preparing exhibits on the history of medicine as part of their research experience.

The participating students represent a range of majors and academic fields at Virginia Tech, from Psychology to Mathematics to History. Financial support was provided by the History Department and Undergraduate Research Institute in the College of Liberal Arts and Human Sciences. More information about the project is available at http://ethomasewing.org/tbhistory/.

E. Thomas Ewing

Department of History, Virginia Tech