The Karabots Junior Fellows Challenge Banned Books

Students in the Karabots Junior Fellows Program examine a set of challenged books on display at the Historical Medical Library

September 24-30, 2017, marked the most recent installment of Banned Books Week. Created in 1982 by the American Library Association (ALA), Banned Books Week calls attention to books that have been challenged or banned by local, state, or federal organizations (particularly libraries and schools), emphasizing the importance of free speech and expression. Described by the ALA as the ”annual celebration of the freedom to read,” Banned Books Week is held every year during the last week of September.

In celebration of Banned Books Week, the new cohort of the Karabots Junior Fellows took their first trip to the Historical Medical Library of the College of Physicians of Philadelphia. There they met with Beth Lander and Caitlin Angelone, the Library’s College Librarian and Reference Librarian, respectively, who introduced them to the diverse materials the Historical Medical Library has to offer. During their visit, the students entered the library stacks, the climate-controlled space in which the College of Physicians’ vast collection of medical-related books and manuscripts are stored. In the spirit of Banned Books Week, they also viewed several books in the collection that have been challenged for various reasons, including books related to witchcraft and sexual health.

Students in the Karabots Junior Fellows Program meet with College Librarian Beth Lander during a tour of the Historical Medical Library

Following their trip to the Library, the students returned to the classroom to discuss the tenets of Banned Books Week. Youth Program Coordinator Kevin Impellizeri challenged them to consider the definitions of “censorship” and “obscenity” and critically examine why individuals or groups would attempt to challenge access to a particular book. They came to the conclusion that “objectionable material” is largely in the eye of the beholder, shaped by a wide variety of factors, including taste, cultural norms, and religious beliefs; as a result, there is no one shared standard for obscenity. They then applied what they learned by going through numerous influential books that have been challenged or banned, including the ALA’s 100 most challenged books of 2000-2009 and selected readings from the 2012 Library of Congress exhibit Books that Shaped America.




The Karabots Junior Fellows Prepare for College

STudents in the KArabots Junior Fellows Program attend a workshop on the college application process

One of the core goals of our youth programs at the College of Physicians of Philadelphia is to help Philadelphia high school students from underserved communities navigate the college application process. Groups affected by violence, discrimination, or economic hardships often face numerous obstacles to academic achievement. Moreover, many of our students in the Girls One Diaspora Club, the Karabots Junior Fellows Program, the Out4STEM Program, and the Teva Pharmaceuticals Internship will be the first in their families to attend college. Preparing for college can be an intimidating and overwhelming endeavor, even in families with adequate resources and minimal socioeconomic obstacles, and it is our goal to help demystify the process through a series of hands-on workshops.

Students in the Karabots Junior Fellows Program attend a workshop on college financial aid held at the College of Physicians of Philadelphia

Currently the fourth cohort of the Karabots Junior Fellows Program, who are now high school seniors, is immersed in the college application process. To help them, the Center for Education has hosted college prep workshops for them and their families; these lessons will continue through the 2017-2018 school year. This month, we tackled two important topics over the course of two sessions. The first addressed financial aid, examining resources available to students to help pay for college. It also went into detail about how to fill out the Free Application for Federal Student Aid, which determines a student’s eligibility for need-based federal and state financial aid (beginning in 2017, the FAFSA is available beginning on October 1, three months sooner than it has traditionally). The second session was an in-depth look at the college application process, addressing what students and families need to know when filling out applications, including a walkthrough of the Common App, a unified college application accepted by roughly 650 colleges and universities.

Youth Program Coordinator Kevin Impellizeri introduces students to upcoming college preparation dates

The old saying goes that it takes a village to raise a child. We are committed to serving as citizens in each of our students’ success.

What they Did On their Summer Vacation: The Karabots Junior Fellows

Students in the Karabots Junior Fellows and Penn SUMR Scholars Programs pose on the marble staircase at the College of Physicians of Philadelphia

Image courtesy of the Penn SUMR Scholars Program

A few weeks ago, the Center for Education welcomed the newest cohort of the Karabots Junior Fellows Program, who took part in an intensive two weeks of medical and STEM education. This year’s theme was Anatomy & Armor, focusing on the natural and artificial ways humans and animals protect themselves from trauma, disease, and predators. During ten content-packed days, they met with guest speakers, took part in hands-on activities, and traveled to interesting locations around the city. Along the way they also learned about subjects in anatomy, general health and wellness, and even a little bit about professionalism and preparing for their future careers.

Week One:

Our program began with our new students getting to know both each other and the College of Physicians of Philadelphia. We welcomed twenty-two students in total, representing a wide variety of backgrounds, neighborhoods, and schools. In a short amount of time, they got to know each other and learned how to work together, taking part in a variety of team-building activities. In keeping with our established history of game-based learning, among their activities was a play session of Steel Plate Games’ Keep Talking and Nobody Explodes, a cooperative computer game that relies heavily on teams learning how to communicate with each other to achieve a common goal: defusing a virtual bomb. In addition to better getting to know each other, they received an introduction to our organization, complete with a tour of the Mütter Museum.

Students in the Karabots Junior Fellows Program play the cooperative computer game "Keep Talking and Nobody Explodes"

On their second day, the Junior Fellows received an immersive experience in the world of physical therapy, examining trauma and recovery. The theme of the day was a scenario in which a patient was injured in a car accident; over the course of their sessions, the students met with health care professionals and took part in activities related to emergency care and rehabilitation. They met with a sophisticated dummy designed to simulate real-life medical conditions, learned how to measure a patient’s vital signs, and practiced using assistive equipment such as wheelchairs and crutches.

Students in the KArabots Junior Fellows Program monitor each other's blood pressure at Drexel University's Physical Therapy Lab

Along the way they took part in lessons related to skin and the human skeleton. Healthcare professionals introduced them to careers in biomedical engineering, sports medicine, neurology, and anesthesiology. They also learned about modern and historic armors. They traveled to the Philadelphia Museum of Art to explore their armory and learn about the design choices that went into medieval armor. A representative from Temple University’s Red Diamond Battalion visited the College of Physicians of Philadelphia to show them modern military protective gear. A former student in the Karabots Junior Fellows Program demonstrated modern athletic equipment.

Week Two:

Their second week began with a day of activities and speakers related to the anatomy of animals. Speakers addressed topics related to comparative anatomy and veterinary medicine. Along the way, the students got to meet live animals, including a snake and a tortoise. The day concluded with a trip to the Academy of Natural Sciences of Philadelphia, where our Karabots Junior Fellows broke into teams and took part in a photo scavenger hunt designed to teach them about natural forms of armor as well as introduce them to the diverse programming the Academy has to offer (fun fact: College of Physicians of Philadelphia Fellow Joseph Leidy served as both the Librarian and Chief Curator for the Academy and was influential in the field of paleontology).

Students in the Karabots Junior Fellows Program pose in front of a dinosaur display at the Academy of Natural Sciences

Several activities this week addressed ways they can help protect and maintain their “armor.” Following a morning yoga session, the students met with experts in nutrition and personal fitness, learning healthy eating habits as well as a bit about self defense. They also learned about the dangers of substance abuse. This led into a series of activities related to first aid, where they learned how to set a splint and what to do in case someone they know experiences a drug or alcohol overdose. They also learned about the benefits of aerobic exercise, taught in part through a session of the rhythm-based video game series Dance Dance Revolution.

Students in the Karabots Junior Fellows Program take part in a yoga session.

Our students also cultivated their research, public speaking, and networking skills. During their first week, the Karabots Junior Fellows divided into groups and selected a specimen from the Mütter Museum. Through the course of the two weeks, they researched their specimen in preparation to deliver small tours to visiting students from the University of Pennsylvania’s SUMR (Summer Undergraduate Research) Program. The SUMR scholars are undergraduate students from underrepresented communities who come to Penn for the summer to get involved in healthcare research projects. Both they and the Karabots students had the opportunity to share their knowledge and get to know each other over museum tours and pizza. Our students also took part in sessions on establishing effective professional connections, building a successful resume, and professional email and social media use.

Wayne Cooper, one of the Karabots Junior Fellows poses with a sample of various vertebrate hearts during a sheep heart dissection

Despite being so full of activities, the week flew by quickly. By the end of the two week session, our students had a better understanding of some of the exciting healthcare careers available to them. We are eager to share more opportunities with them when they return in the fall.

CPP Curiosities: The Iron Lung

Logo for CPP Curiosities

Greetings, patient historico-medico aficionados. After a brief hiatus, your monthly dose of the medically weird is back again. In keeping with our transition from CEPI to the Center for Education, CEPI Curiosities is also receiving a new moniker: CPP (as in College of Physicians of Philadelphia) Curiosities. Make no mistake, however, despite the new name we are sticking to our tried-and-true formula of medical history stories to surprise you or at the very least make you look at the world of medicine just a bit differently.

This time around we are tackling the strange and fascinating history of the negative pressure ventilator, more commonly known as the “iron lung.”

Emerson Iron Lung at the Mütter Museum

Emerson Iron Lung at the Mütter Museum

“Iron Lung” is a colloquial term for a variety of artificial respiration machines that encapsulate all or part of a patient’s body. They help a person breathe through a method called negative pressure ventilation where the air pressure surrounding the patient’s body is reduced, forcing their lungs to expand and take in air; the pressure around the patient is then increased, causing them to exhale. For a time, iron lungs were a common treatment during the twentieth century for conditions where a patient could not sufficiently breathe unassisted.

However, they are most commonly associated with one particular disease: polio. Also known as infantile paralysis or poliomyelitis, polio is caused by the poliovirus, a contagious virus most commonly spread through infected feces that comes into contact with a patient’s mouth. The majority of people exposed to the poliovirus exhibit no symptoms; according to the Centers for Disease Control and Prevention, one in four people infected with the poliovirus will have relatively mild symptoms, including sore throat, nausea, fatigue, headaches, and stomach pain, and these symptoms generally go away after a few days (this is known as “abortive polio”). However, a small percentage of people exposed to the poliovirus develop temporary or permanent neurological symptoms, ranging from light sensitivity and stiffness to muscle spasms to partial or total paralysis.

Image of a patient's legs with chronic anterior poliomyelitis, Source: Historical Medical Library of the College of Physicians of Philadelphia

Image of a patient’s legs with chronic anterior poliomyelitis, Source: Historical Medical Library of the College of Physicians of Philadelphia

According to our sister page, History of Vaccines, the earliest reported polio outbreak in the United States took place in 1894. The nation’s most severe outbreak occurred in the 1930s-1950s. The development of polio vaccines and public health initiatives to inoculate the public significantly reduced the number of polio cases. Thanks to vaccines, polio has been largely eradicated in the developed world (it was eliminated in the US in 1979). However, periodic outbreaks occur in areas with limited or inadequate medical resources. Between 2013 and 2015, a polio epidemic spread through Syria and into neighboring Iraq followed by a second outbreak in Syria in June 2017 as well as another in the Congo around the same time.

Conceptually, negative pressure ventilation dates back to the late 1700s, and the earliest negative pressure devices emerged in the mid 1800s. In 1864, Alfred F. Jones of Lexington, KY, filed the first patent for a negative pressure respirator. His device, which he dubbed a “Restorator,” required the patient to sit upright in a small chamber with only their head exposed, covered in a specialized hood to maintain an air seal. Air circulated through the chamber through a hand pump. However, it’s unclear if Jones ever developed a model for mass production. In 1876, a French physician named Eugene Woillez developed what is considered the first functional negative pressure ventilator. Woillez’s “Spirophone” allowed for a patient to lie flat on their back, encasing them up to their neck in a sealed enclosure. Air was pumped into the Spirophone through the use of hand-operated bellows.

Image of Alfred Jones' "Restorator" from his patent application US Patent No: US44198

Image of Alfred Jones’ “Restorator” from his patent application US Patent No: US44198

However, the negative pressure ventilator did not receive wide usage or exposure until the early 20th century. In 1928, a pair of Harvard University professors–Drs. Philip Drinker and Louis Agassiz Shaw–developed an automated negative pressure ventilator. Similar to the Spirophone, a patient lay flat on a movable table with all but their head and neck encased within the device. The Drinker respirator generated negative pressure via a motor that pumped a bellows (this silent film demonstrates it in action). They initially tested the device by conducting preliminary experiments on a cat before moving into to human testing on an eight-year-old girl with respiratory paralysis from polio. According to Drinker’s later accounts the girl’s breathing significantly improved after being encased in the Drinker respirator for a short period of time, and their “iron lung” quickly gained wide circulation as a treatment for polio-induced respiratory failure (Louis A. Shaw, “Cutaneous Respiration of the Cat,” American Journal of Physiology. 85 (1928): 158-167; Philip Drinker and Charles F. McKhann, III. The Use of a New Apparatus for the Prolonged Administration of Artificial Respiration: I. A Fatal Case of Poliomyelitis. JAMA. 92.20 (1929): 1658-166). In 1931, a Boston machinist named John Haven Emerson devised improvements for the Drinker and Shaw design; reportedly, Emerson approached Drinker with his ideas but found a tepid response, prompting him to design and sell it on his own. The Emerson Iron Lung proved lighter, more efficient, and significantly cheaper to produce than the Drinker model and became a staple in polio treatment wards across the country (Drinker also unsuccessfully attempted to sue Emerson for patent infringement). The College of Physicians has an Emerson Iron Lung among its vast collection; however, it is not currently on display.

During the polio outbreaks of the 1930s-1950s, if paralysis impeded a person’s ability to breathe (respiratory paralysis), they would be placed into an iron lung until such time as they could breathe on their own, usually after 1-2 weeks of treatment. However, in cases of extreme paralysis, patients may periodically be encased in one over the course of months or years. For those curious about what it is like to be in an iron lung, in 2010, the Journal of the Royal Society of Medicine published an account from Marshall Barr, a patient who regularly used an iron lung for fifteen years.

Robert Hicks, Mütter Museum Director Robert Hicks in an iron lung for an episode of the YouTube series Grey Matter

Robert Hicks, Mütter Museum Director Robert Hicks in an iron lung for an episode of the YouTube series Grey Matter

With the rise in positive pressure ventilation devices (the kind used in modern ventilators), negative pressure respirators like the iron lung generally fell out of favor. However, there are reportedly a small handful of patients who still utilize an iron lung to help them breathe.

Until next time, catch you on the strange side!

The Out4STEM and Teva Interns Become Crime Scene Investigators

Sheets of fingerprints collected at the Arcadia Crime Scene House are spread across a table.

During these next two months, students in our various youth programs are active in both the classroom, in the laboratory, and in the community. Recently, students from the Out4STEM Internship program journeyed to Arcadia University to visit the Arcadia Crime Scene House. Opened in 2015 as part of Arcadia’s Forensic Science Program, the Crime Scene House provides simulations of crime scenes for students to home their observation skills. Together, the interns examined a simulated crime scene and gathered evidence, such as fingerprints, blood spatter, and shoe prints.

Students from the Center for Education's youth programs gather evidence from a human dummy simulating a victim at the Arcadia Crime Scene House

Meanwhile, students in the Teva Pharmaceuticals Internship Program conducted their own crime scene investigation here at the College of Physicians. Under the guidance of Gladys “GG” Seibert, an expert in crime scene analysis, the interns examined a mock crime scene. Braving the summer heat, they meticulously gathered evidence. Endowed with their newfound investigatory experience, they will take part in other lessons in processing that information. Along the way, they will also investigate the societal impact of violent crime and mechanisms for addressing and coping with violence.

Students in the Teva Pharmaceuticals Internship Program investigate a mock crime scene at the loading dock behind the College of Physicians of Philadelphia

The Teva Interns Reach New Heights

Students in the Teva Pharmaceuticals Internship Program pose in the Liberty Place Observation Deck

While many students are taking the summer off, the students in the various youth programs of the Center for Education have been hard at work expanding their knowledge and learning how to make a difference in the world. Last week, we welcomed the latest cohort of the Teva Pharmaceuticals Internship Program. They will take part in four weeks of lessons, field trips, and hands-on activities that will expand their understanding of science, forensics, and social justice. As part of building a greater sense of community within the City of Philadelphia and among each other, the interns met with Michael Nairn, professor of Urban Studies at the University of Pennsylvania and a regular participant in our exploits here at the Center for Education. Last week, Professor Nairn gave each student a map and asked them to color in sections of the city in which they felt safe in one color and those where they did not feel safe in another. Together they compared their results and offered their thoughts on the layout of the city.

On Monday, they continued their discussion outside the classroom and traveled to the Liberty Place Observation Deck. From the 57th floor, our Teva interns got a glimpse of Philadelphia from one of the tallest buildings in the city. Thanks to the breathtaking view and a brief lecture from Professor Nairn, the students had the opportunity to view the city from a different perspective, both literally and theoretically. They marveled at the beauty and majesty of Philadelphia’s architecture and landscape, including observing the city’s grid-based layout and unique neighborhoods. They each tried to pinpoint notable landmarks as well as their own neighborhoods, with varying levels of accuracy.

Students in the Teva Pharmaceuticals Internship Program hear a lecture from Penn Urban Studies professor Michael Nairn at the Liberty Place Observation Deck

It was a view of the city they had never witnessed before and certainly one they won’t soon forget.

…In with the New

Logo for the Center for Education of the College of Physicians of Philadelphia

With the end of the school year comes a time for self-reflection and re-invention. In the spirit of renewal, we are happy to announce some dramatic new changes to our department and our online presence. We now have a new name: say goodbye to the Center for Education and Public Initiatives (CEPI) and hello to the Center for Education (CFE).

You may also notice we have changed the name of our weblog from CEPI@CPP to Mütter EDU. This is to reinforce our close connection with the Mütter Museum. This close connection is reflected in our new social media handles. You can now follow us on Instagram or Twitter under the handle @mutterEDU. Keep a careful eye on this space for other new changes and surprises.