Midnight in the Library

Right now, I am reading The Midnight Library by Matt Haig. It’s a fanciful story of a woman in limbo between life and death who finds herself in a magical library, and each book represents one of the lives she could have lived had she made even one tiny different decision. She then finds herself in many of these lives, experiencing what could have been.

This book got me thinking about how NLM helps people experience lives that could be. I see this on two levels:

The first is the scientific pathway: What if . . . ? What if we knew more about the interactions between evolutionary forces and molecular constraints (like the work of Aravind Iyer, PhD), or fully appreciated the potential of proteins for genome engineering (like the discoveries made by Eugene Koonin, PhD), or could envision how and why proteins fold or switch their folds (as explored by Lauren Porter, PhD), or had the power to enable machines to understand human thought (like the research from Dina Demner-Fushman, MD, PhD). In addition to the discoveries by our NLM intramural researchers, our vast literature and data repositories hold answers that could change lives: why some genetic structures lead to human characteristics, or why a certain biochemical compound helps prevent infection. We help scientists discover these pathways and connections by providing them with the tools to uncover what could be.

The second is how NLM helps people see their what if using the amazing richness of the resources that we make available through our collections. Our resources—which encompass clinical insights, medical information, care guidelines, and self-management—help clinicians determine how to care for people with complex diseases or diagnose an illness in a timely manner. Our repository of clinical information available through PubMed ensures that those in need can access well-reasoned, recognized guiding principles for their care, and our MedlinePlus web resource provides patients and their families and friends with reliable, up-to-date health information to support and encourage healthy behavioral changes.

As in The Midnight Library, books alone do not inspire discovery, guide clinical care, or inform self-management. In Haig’s novel, a fictional librarian who knows the collection shows the main character how to select books by carefully listening to her goals and needs. It is the main character’s engagement with the books that helps her explore the lives she could have lived. At NLM, we too have librarians—located in Bethesda, Maryland, and around the country through NLM’s Network of the National Library of Medicine—who organize the library’s collections and guide patrons toward the best choice of resources. Our resources must be findable, accessible, interoperable, reusable, and actionable! And then, the person—scientist, clinician, patient—must actively engage with the material.

As we approach the future of data-powered health, guided by the NLM Strategic Plan (2017-2027), we will fulfill our mission to collect biomedical literature, organize it, preserve it, and make it accessible to the world. As the knowledge of health and biomedicine continues to grow faster than we can process, we will turn our attention to applying emerging tools, including machine learning and artificial intelligence, to make it easier to find our materials and more efficient to examine them. Through our Extramural Programs, we will continue to stimulate new ways of presenting information to scientists, clinicians, patients, and the public so they can explore possible lives to be lived and test out their promise of better health for society. What lives can we help you explore?

Author: Patti Brennan

Director, US National Library of Medicine

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