Oral Histories of NLM’s Software Development: The Not Aways Smooth Process of Technological Change

As a part of my National Digital Stewardship Residency (NDSR) project, I’m interviewing staff members about their experiences developing and using software at the National Library of Medicine (NLM). Doing these interviews may be my favorite part of the job right now. Each of these staff members has had invaluable insight into the cultural and technical aspects of software development and into the history of NLM itself. Not to mention, I’ve heard a funny story or two.

Most recently, my mentor and I drove to Frederick, MD to interview a retired staff member about her work on NLM’s software products. Before I delve it the interview, I need to thank my mentor for joining me on this Thursday morning adventure and for BBQ after. My mentor is a total mensch.

We drove in Frederick to interview Rose Marie Woodsmall, who worked at NLM for thirty years and was instrumental on AIM-TWX, Grateful Med, and innumerable other projects. Throughout the first two months of my project, her name kept popping up in interviews, in documentation, and even in casual conversations with staff members. Organizing the interview, however, was a bit difficult as Woodsmall had retired and started a sheep farm in rural Maryland. Perhaps my only regret from this interview was that I did not get to meet any of the sheep. Even without the sheep’s input, the interview provided amazing background and context.

The interview was filled with anecdotes, including how Grateful Med got its name. (You’ll have to wait for a later post with that story. I have a long blog post planned about naming conventions at NLM and how that affects research and institutional culture.) Perhaps the most interesting aspect of the interview, however, was how Woodsmall was able to outline the lived experience of major technological shifts in computing and how the technological changes were not always smooth. Woodsmall frequently acted as a liaison between software users and developers on development projects, and she had to navigate relationships between many stakeholders.

The overall push of software development through the years that Woodsmall was a staff member at NLM was towards more user-friendly systems. MEDLARS I, the earliest of NLM’s computerized catalog search systems, required an expert user. Implemented in 1964, it was only searched by specially trained medical librarians, and the training was two weeks long! These medical librarians worked in libraries and hospitals around the world and helped facilitate access to NLM’s resources, even at a geographic distance. It was a big step forward in medical librarianship and medicine in general.

After MEDLARS I, however, came MEDLARS II which allowed for online search capabilities and was slightly less cumbersome to use, although not ‘user-friendly’ or ‘online’ in the ways we understand those terms today. After implementation in 1971, MEDLARS II still required specialized training, and although it was ‘online’ and allowed remote searches of databases in real time, it was not connected to the Internet. In fact, the Internet had not yet been invented. MEDLARS II relied on dedicated phone lines to establish its network connection, and computers that were connected to MEDLARS II were not necessarily connected to any other networks. Some machines were dedicated to simply searching the NLM databases. These machines did not look like computers today. Some were teletype machines, like the one pictured below.

Image provided by the Providence Public Library
Image provided by the Providence Public Library

Although MEDLARS II sounds very limited considering current search capabilities on the Internet, it was another step forward for medical librarianship. It seems like common sense to assume that everyone welcomed the switch from batch-processing to online search. After all, why not make life easier? However, as Woodsmall pointed out, the switch was not universally applauded. Some of the search analysts, accustomed to their particular place within their individual institutions, were suspicious of the new technology and were concerned about losing their sense of prestige. One librarian even hid the teletype machine used to connect to the network in a closet. She did not want her patrons to use it, and she did not want them to see her use it. Eventually, people saw its utility and the transition became smoother.

Woodsmall talked about similar issues when NLM began to implement Grateful Med widely. Many librarians, even up to the 1990’s, were nervous about allowing end-users to search a database without their assistance. In a Letter to the Editor in the Bulletin of Medical Library Associations published in January 1994, Catherine J. Green, a librarian at Bethesda Memorial Hospital in Boynton Beach, Florida, quotes a recent lecture that argues that allowing end-users to search the database on their own “is not only a dumb idea, it is a dangerous idea!” Green and others were worried that doctors would inefficiently or inaccurately search for medical information using Grateful Med, thus impacting the quality of patient care. This concern is not unfounded, and although Grateful Med is now frequently praised for helping democratize access to medical information, this concern at the time of implementation is an important aspect to the technology’s history.

The point is that change is not always universally heralded, and it is possible to forget that fact when those changes are later determined to be technological progress. The move from batch-processing to online search and then to end-user search capabilities are all seen as positive advancements in medicine and medical librarianship now. But, when these changes were implemented, they were not always seen as progress in medical librarianship. Disagreements and long discussions about the viability of these technologies cannot be overlooked because they are an integral part of the way that technological change occurred.

Interviewing someone like Woodsmall is helpful because she was able to highlight those discussions and the more contentious aspects of software development. Implementing new technologies frequently requires advocacy, both within the organization and with users. As I continue to research the history of software development at NLM, interviews will remain important as they help contextualize the technology in the disagreements, debates, and compromises that occur throughout development and implementation.