2nd verse: same as the first

So here I am gearing up to teach consumer health for the first time at TWU. Last semester it was intro to health science librarianship, and I found myself a bit adrift, but having to be ok with that. If I am to walk the walk, what I teach must be transparent and participatory, should be integrated with ideas of evidence-based practice. What does that mean?

• not making truth claims
• being ready to be wrong
• being ready to be unsure
• being ready to base my work and claims on best practices
• being capable and willing to assess outcomes, acknowledging my own tendency to bias

There is no comfort-space here in health science librarianship. We don't know where we're going but past the uncertainty, there is (I feel it!) opportunity. Reading Patricia Anderson's 'lessons learned' post, in which she assembles the results of a lively, ongoing conversation taking place weekly via tweet, the open door is visible. There are permeable barriers between health professionals and health consumers and health science librarians. There is, as there was with Second Life, a tendency for those uninvolved to brush away excited claims from new frontier explorers. There is, as with calls for our involvement in new ways such as informationists, a lack of evidence to support such excursions - twinned with a recognition by those involved that this matters.

I wonder how to provide glimpses of the possible to aspirant health information professionals when it is anything but clear to me. Is what I need try to convey the uncertainty and the excitement? When new students ask, where is health science librarianship headed - how can I say I know (and give false comfort), when I do not (and still, find challenge as I have for several decades)?  It has to come from honesty and transparency, presenting myself as a learner too. As I am.

A delicate balance

Yesterday, I practiced walking/running intervals in the local park. For the first time, I managed to run (ok, jog) 1/2 mile straight. From the perspective of June, when I waited to be sure that I'd be unseen in my ridiculous and clumsy attempt before jogging what may have been a whole 200 yards, this is a remarkable accomplishment!  I am insufferably pleased with my efforts.

It's evidence that while I felt myself tethered to my computer (with kudzu, I imagined, grown there while in Chapel Hill), there is life beyond doctoral studies, beyond the virtual. The body abides, but is moaning its neglect, and slowly creaks through enforced paces. Stasis seems most natural, but is an illusion: the reality is a gradual decline that goes unnoticed, but for the familiar aches of a chairbound body. There is an inevitability to that subsidence, from which we shy away.

When I walk 1/8th mile, then run 1/4, I give my legs time to recover. Underused muscles loosen, breath and heart slow; by the end of that time I am ready to pick up the pace again. At times my body moves as it is meant to do, all parts in sync, and I find myself closer to the dream of lightness and joy. Experienced runners pass me, reaching with gazelle-strides, shining with sweat, nearly airborne. It is not yet possible that I could be among them. Do I want to be? - I continue to look, and remember myself as a child sprinting barefoot, put to run with the boys because I outran all the girls.

During other moments, I feel twinges and the stubborn pull of tiredness, and look for the marker that means I can slow down, utterly bound to the earth. In order to improve my stamina and strength, I have to know my body and respect it, learn to listen to those messages.  But how do I discern the difference between limits that must be pushed, and those that should be respected?  I learn.

I must have both moments. Limits to presence: transcendency. Pragmatism, limit-escaping; knowing self, dreaming of possible selves. Teaching - and LIS itself - are the same for me, but involve the conscious inclusion of the what is and what might be, what is certain/uncertain; what is known and what (everything) should be questioned.

The power and passion of LIS is thoroughly grounded in both historical presence and near-ethereal idealism, and both sustain us and drive us toward the future. We are limited by earth-boundedness, in this sense our overwhelming awareness of political and economic realities, the small and large fires faced daily.

Can we retain our idealism and drive for change as a positive force through the present era?  The lift and memory of flight, insubstantial as they seem to be, must be nourished by all in order to retain viability as a profession.

No-GoLocal - we give away the keys

Seeing the story here connected dots between the recent announcement that NLM is cutting the cord on support to GoLocal efforts. A quote:

People want to know what's going on locally. People want to shop locally. People want to network locally. And hyperlocal services make it easier to engage in and market to a local community. Technology need no longer be feared by local businesses as something that would drive their customers elsewhere - namely online.

Although location-based social networks such as Foursquare and Gowalla have received significant attention as part of this trend, they are far from the only services. Hyperlocal search and news sites are two other services that have seen recent growth.
Last week, Milo.com, a website that enables shoppers to research products online but then make their purchases locally, added products and real-time inventories for over 100 independent, mom-and-pop stores across the country. While Milo.com has served the "big box" stores for some time, this move to incorporate smaller retail outlets marks another way in which the local is starting to take advantage of online opportunities. 

 This makes my head hurt. Just as we (speaking generically of medical libraries) flip the switch on local efforts to support a growing number of healthcare consumers, commercial ventures find new blood by tracking to the 'hood.

I feel as if we've just ensured that we will continue to matter less at the precise time when we should be working to matter more to those who need support. Says NLM, usage is low -- and there were always problems, anyway:

However, while a few Go Local sites managed to maintain an atmosphere of success, there were always concerns expressed by staff at the sites and at NLM, regarding the amount of staff time required to maintain each site, low use at many sites, the inability of some sites to keep records current, shrinking library budgets that resulted in fewer resources to support and sustain sites, and NLM inability to increase funding levels due to a tight federal budget. 

I can only commend those health science libraries who plan to transform their years of effort to community resource pages -- but I wonder why we can do no more than shake our heads. Or are we? Maybe it's the money, and all people can do is keep treading water?  I don't know what the thinking is here, but I've seen nothing on the Medlib-L list, no announcements from anyone.  And I think we need a Bill Gates in our corner here. Just sayin. And if you'd like to think about this a little more, check out the first comment on the story:

I think this is a great article! I'd like to add that the foundation for the hyper-local is missing. There are two different things happening:
1) Companies like FourSquare, Gowalla, Google are all building a database of local listings to provide services. It's a global race to get the data organized. Whoever decides to share this data with everyone else will facilitate the creation of thousands of more companies/services.
2) Mapping companies, like Micello, are only focusing on providing maps for specific venues (extremely hyperlocal). If these maps are provided for others, we'll see a new wave of innovation.

Posted by: John Macon | April 26, 2010 6:50 PM

Faultlines: Vital signs for hospital libraries

If you have not read the Vital Pathways report, out in the October 2009 issue of JMLA, I recommend it. This symposium, published as a group of articles, is the outcome of an initiative begun by the former MLA president MJ Tooey, in responding to numerous reports of hospital library closings, budget cuts, and job losses.

I had been anxiously anticipating it, because I was not able to find much on the status of hospital libraries, and for my dissertation research proposal, focused as it is on hospital librarians, an understanding of who we are seems important.

Following an unsuccessful attempt, just now, to find something - almost anything! - on a blog, from MLA, published, pre-published, scrawled on a wall somewhere, I report to you that I am underwhelmed by the voluminous reaction of the hospital and medical library community to this important report.

We've all always been vulnerable to economic vagaries. Reports from an earlier survey cite “major negative changes” (Ben Shir, 1989) that included budget cuts or layoffs (37%), downsizing (6%) and budget or hiring freezes (4%) at a time when managed care brought about increased competition for the healthcare dollar.

In Vital Pathways, once again, we have faultlines: the rate of library closings doubled during the years 2007-2009 (a change from 10% - 22% of respondents reporting this, and 23% - nearly a full quarter of of the 127 libraries involved - reported staff downsizing.  No clue here about whether these numbers are in any way representative, and no real way to become any less clueless, which I find incredibly weird.

I seem to always end with questions, so here are more: Does the Vital Pathways report pose questions that need to be asked, or that we're interested in asking (or attempting to answer)?  Are our only answers 'change or die'?  Is the hospital library our own Atlantis?  (I know - too much drama in that last!) Are we emulating healthcare itself, in that certain pieces of information are left unshared, a matter of mystique, a proprietary act of legerdemain?  I have seen no discussion about it all, post Report - it's as if we are holding our breaths. Probably, we're all too busy book-taping the fort together, getting through. 

From Carla Funk, on Medlib-L, in response to a question about how many hospitals have medical libraries:

It is estimated that there were between 5,795 (AHA) and 6,224
(Directory) hospitals in the U.S. in 2004/2005 based on AHA data and information in the Directory of Hospital Personnel, 2005 edition. According to the AHA, there were 6,853 registered hospitals in the U.S. in January 1990, a decline of 15.5% from the 2004 figure. It is further estimated that there were between 1,950 (NN/LM) and 2,513 hospital libraries (Directory of Hospital Personnel) in 2004/2005. According to the AHA, it is estimated that there were 3,030 hospital libraries in 1990. Therefore, comparing this figure to the 2004/2005 data, it is estimated that the number of hospital libraries has declined between 17.1% and 35.7% between 1990 and 2004/2005.

Among other responses in the topic summary:

"I have been trying to track this information for the past 19 years with absolutely no credible success."

More questions: why is this information nearly inaccessible - to the extent that it took several years to gather the information about library changes through the MLANet site?  Where is information about non-members of MLA (and why they are non-members), our brethren (sistern?)?

Hmmph. For a profession reliant upon data, etc. etc. Is this our way forward?



Ben-Shir, R.H. (1989, August). Survey confirms major changes in hospital libraries. MLA News, 217:8.

Funk, C. (2008, June 3). Response to topic on Medlib-L "SUMMARY: Percentage of hospitals with Medical Librarians. Retrieved from Medlib-L archives March 16, 2010.