I Still Walk in Wonder

Each morning, I still walk in wonder across the NIH campus to Buildings 38 and 38A, the home of the National Library of Medicine.

A few weeks ago I arrived on campus as a glorious sunrise greeted me, passing the Natcher Center (Building 45), where our NCBI team occupies three floors, and our parking lot, already full of cars from the employees who come in early or work overnight to ensure our resources are available 24/7.

We have some 1,700 women and men working here, so even 16 months in to my time as director, I’m still meeting staff members for the first time. Last month, besides that glorious sunrise, I encountered Tory Detweiler on my way in to work and learned a bit about her.

Her story is worth sharing.

Two women sitting and smiling
Dr. Brennan and Tory Detweiler

Tory has worked in the NLM History of Medicine Division for the last four years, but, as she explained to me, she has been at NLM for 29 years, 8 months and 18 days. (Yes, she knows the precise count!) She actually began at the Library in 1978, working part-time while a student at Walt Whitman High School in Bethesda, Maryland, and then later, while she was in college.

Tory works with content in NLM’s archives, ensuring everyone has access to these treasures. Presently, she’s photographing 500 public service posters developed during the AIDS epidemic so they can be cataloged and added to NLM Digital Collections, but she has also honed her scanning, cataloging, and Photoshop skills.

Making material accessible has special meaning to Tory. As a person who is deaf, she understands just how important it is to make information available to as many people as possible.

The unit where she works, the Archives and Modern Manuscripts Collection, handles the personal papers and organizational records from predominantly American medical practitioners, biomedical scientists, health policy planners, and medical societies from about 1850 to the present.

Tory marvels at how medicine has evolved over the years from herbals to synthetic drugs, for example, and takes inspiration from physicians whose careers challenged the norm. (“Leonidas Berry should not be forgotten,” Tory said. “I’m impressed by how he fought for civil rights in the medical field.”)

When not at work, Tory is a travel photographer and a passionate genealogist. She is writing a book about her great-great-great grandmother’s family based largely on letters they exchanged with Tory’s great-great uncle, who joined the California Gold Rush in 1852, moving to San Francisco from Baltimore in hopes of striking it rich. (He didn’t.)

Tory’s story, of course, is just one of 1,700 here at NLM. Each of the women and men who works here brings to the job talents, skills, and a backstory, applying them to NLM’s mission, the work of their teams, and our overall success.

I enjoy meeting our staff, whether via formal or impromptu meetings.  So, to my NLM colleagues, the next time you see me in the hallway or on campus, please introduce yourself. Together we will be moving this great Library forward.

The more people I meet, the more I know I have a lot of company walking in wonder.

Happy Birthday, Blog!

Today marks one year since we launched Musings on the Mezzanine.

Surprisingly, I’ve found that writing for it has often been the high point of my week.

I like having a way to communicate important happenings here at NLM. I also like using the blog as a way to wrestle with ideas. Many times I have been puzzling about how to approach a managerial challenge or make some headway with a project only to find that writing a blog post reveals a fresh perspective or new direction. Sometimes I write directly about what I’m mulling over; other times it’s as if my brain is working in parallel, focused in part on the story I am telling and in part elsewhere, sifting and winnowing through that vexing work issue.

Do you have a favorite post? I have many. Indeed, I probably like all of them, but sometimes one or another holds special meaning. We announced the re-design of the BD2K data science program through this blog back in January. In June, I shared reminiscences of my good friend, Judith Caruthers, and for a bit, this long-gone friend came back to life for me. I  introduced you to the great civil rights leaders during Black History Month, and later took you on my vacation pilgrimage through some of the civil rights shrines in the South. We said goodbye to Betsy Humphreys and honored the great Joe Leiter through this blog. And I introduced you to my family, my colleagues, and the important work here at the National Library of Medicine.

I have been delighted to offer the “bully pulpit” of Musings, as we call it, to others who have something important to say to our community. Whether it is about the journey through the Associates Fellowship program, the significant role of hospital libraries, the next generation of clinical decision support, or confirming the Internet in space, these guest bloggers have brought their unique voices and perspectives, and for this I am grateful. Insights about our NLM resources are best conveyed by those closest to them, and I am immensely thankful to NLM colleagues Joyce Backus, Dina Demner-Fushman, Kathel Dunn, Ashley Hintz, Jeff Reznick, Fred Wood, and others who took the time to tell our story.

Sometimes I re-read old blog posts. They’ve helped me track the trajectory of my first year, and I love looking at the pictures and reading the comments. I sometimes wonder what prompted me to delve in to a particular theme, often reminiscing on the spark—a conversation with a staff member, a painting at an exhibition—that led to a specific post.

This blog would not be possible without the energy, vision, and skills of my colleague Mary Ann Leonard. Mary Ann, a librarian-turned-communications specialist, encourages me, cajoles me, and even inspires me to use this blog to increase your engagement with NLM. She helps me find my voice, and, many times, translates that voice into understandable prose, accompanied by informative and interesting pictures. Thanks, Mary Ann!

At one point over the summer we considered changing the pace of the blog, maybe posting only every other week, but the urge to connect, to persuade, to tell our story, runs too strong, so every Tuesday morning at 9 AM I hold fast to my sacred time and write the next blog post.

So next Tuesday, or the Tuesday after that, what would you like to see me address in this blog? Or just as importantly, who out there needs a “bully pulpit” to share your ideas or concerns about medical libraries, health information, open access, health disparities, or anything else of interest to the NLM community? I invite you to propose an idea, draft a post, and tell the world.

I get to do this every week, and it’s wonderful, so join the party! I can’t promise cake, but the conversations are excellent.



Calling on Librarians to Help Ensure the Credibility of Published Research Results

Guest post by Jennifer Marill, Kathryn Funk, and Jerry Sheehan.

The National Institutes of Health (NIH) took a simple but significant step Friday to protect the credibility of published findings from its funded research.

NIH Guide Notice OD-18-011 calls upon NIH stakeholders to help authors of scientific journal articles adhere to the principles of research integrity and publication ethics; identify journals that follow best practices promoted by professional scholarly publishing organizations; and avoid publishing in journals that do not have a clearly stated and rigorous peer review process. The notice identifies several resources authors can consult when considering publishing venues, including Think Check Submit, a publishing industry resource, and consumer information on predatory journals from the Federal Trade Commission.

Librarians have an especially important role to play in guiding researcher-authors to high-quality journals. Librarians regularly develop and apply rigorous collection criteria when selecting journals to include in their collections and make available to their constituents. Librarians promote high-quality journals of relevance to their local communities. As a result, librarians are extremely familiar with journal publishers and the journals their constituents use for research and publication.

The National Library of Medicine (NLM) is no exception. One of NLM’s important functions is to select journals for its collection. The journal guidelines from the NLM Collection Development Manual call for journals that demonstrate good editorial quality and elements that contribute to the objectivity, credibility, and scientific quality of its content. It expects journals and journal publishers to conform with guidelines and best practices promoted by professional scholarly publishing organizations, such as the recommendations of the International Committee of Medical Journal Editors and the joint statement of principles of the Committee on Publication Ethics, Directory of Open Access Journals, Open Access Scholarly Publishers Association and World Association of Medical Editors.

Criteria for accepting journals for MEDLINE or PubMed Central are even more selective, reflecting the considerable resources associated with indexing the literature and providing long-term preservation and public access to full-text literature. MEDLINE currently indexes some 5,600 journals; PubMed Central has about 2,000 journals that regularly submit their full content. PubMed Central is also the repository for the articles resulting from NIH-funded research.

For the most part, NIH-funded researchers do a good job of publishing in high-quality journals.  More than 815,000 journal articles reporting on NIH-funded research have been made publicly accessible in PubMed Central since the NIH Public Access policy became mandatory in 2008. More than 90 percent of these articles are published in journals currently indexed in MEDLINE. The remainder are distributed across thousands of journals, some 3,000 of which have only a single article in PubMed Central. While many are quality journals with sound editorial practices, effective peer review, and scientific merit, it can often be difficult for a researcher-author to evaluate these factors.

That’s where local librarians can be of great assistance. And many already are—helping researchers at their local institutions select publishing venues.

If you have a good practice in your library, let us know about it so we can all learn how best to protect the credibility of published research results.

Jennifer Marill serves as chief of NLM’s Technical Services Division and the Library’s collection development officer. Kathryn Funk is a program manager and librarian for PubMed Central. And Jerry Sheehan is the Library’s deputy director.

Mining for Treasure, Discovering MEDLINE

Reusing a noteworthy dataset to great result

Guest post by Joyce Backus and Kathel Dunn, both from NLM’s Division of Library Operations.

As shrinking budgets tighten belts at hospitals and academic institutions, medical libraries have come under scrutiny. In response, librarians have had to articulate the value they bring to the institution and to the customers—students, researchers, clinicians, or patients—they serve.

In 2011-2012, as such scrutiny swelled, Joanne Marshall and her team set out to study the very question these medical institutions faced: Do libraries add value? They collected 16,122 individual responses from health professionals at 118 hospitals served by 56 health libraries in the United States and Canada. The team sought to determine whether physicians, residents, and nurses perceived their libraries’ information resources as valuable and whether the information obtained impacted patient care.

The resulting article, “The Value of Library and Information Services in Patient Care,” published in 2013, gave medical librarians strong talking points, including the overall perceived value of libraries as time-savers that positively impact patient care.

Now the datasets from that study are being reused to great result.

Over the last year we teamed up with Joanne Marshall and Amber Wells, both from the University of North Carolina-Chapel Hill, to dive into the data.

Our goal: to understand the value and impact of MEDLINE in medical libraries.

We re-discovered (as has been written about before) the value of MEDLINE in changing patient care. We also found its preeminent role shines even more brightly in a dataset like this one that includes other sources. We saw the significance of MEDLINE as a single source of information but also as a source used in combination with full-text journals, books, drug databases, websites, and colleague consultations.

We were reminded, too, of the importance of the National Network of Libraries of Medicine (NNLM) to our work; the trust in the NNLM; each library’s connectedness to the other; and how the everyday web of relationships prompts cooperation and collaboration, including the successful implementation of the value of libraries study itself.

For us this re-discovery comes at a key time, when we’re examining NLM products and services as part of the strategic planning process. We are actively identifying methodologies and tools to elevate all our collections—from datasets to incunabula—and make them greater engines of discovery in service of health.

But what about your library’s resources?

The data mining challenge we gave ourselves is our guide for medical librarians everywhere: look at your data, what’s in front of you, and then others’ data. What can they tell you about what’s happening now, what will likely happen in the future, what’s being used, and how it’s being used?

If you don’t know where to start, check out the Medical Library Association’s Research Training Institute, recommended research skills, and mentoring program. In addition, the NNLM’s site on program evaluation includes tools for determining cost benefit and return on investment.

Librarians positively impact health care and health care research. Now it’s time to have that same impact on our own profession. The data are there. It’s time we see what they have to tell us.

More information

Value of Library and Information Services in Patient Care Study


Lindberg DA, Siegel ER, Rapp BA, Wallingford KT, Wilson SR. Use of MEDLINE by physicians for clinical problem solving. JAMA. 1993; 269: 3124-9.

Demner-Fushman D, Hauser SE, Humphrey SM, Ford GM, Jacobs JL, Thoma GR. MEDLINE as a source of just-in-time answers to clinical questions. AMIA Annual Symposium Proceedings. 2006:190-4.

Sneiderman CA, Demner-Fushman D, Fiszman M, Ide NC, Rindflesch TC. Knowledge-based methods to help clinicians find answers in MEDLINE. Journal of the American Medical Informatics Association. 2007 Nov-Dec; 14(6):772-80.

Joyce Backus serves as the associate director for Library Operations at NLM. Kathel Dunn is the NLM Associate Fellowship coordinator.

Photo credit (ammonite, top): William Warby [Wikimedia Commons (CC BY 2.0)]

Essential and Invisible

On the importance of being recognized

Recently I had the pleasure of attending the annual meeting of the South Central Chapter of the Medical Library Association. There I met librarians and other information management professionals who serve the South Central Region of the National Network of Libraries of Medicine, many of whom have been quite busy lately ensuring continuity of library operations through Hurricane Harvey and its aftermath.

impromptu group photo
Dr. Brennan visits with staff from the NNLM/South Central Region in Albuquerque, October 15, 2017.

I attended the meeting to give an update of how things are going back here in Bethesda, describe my vision for NLM’s role in data-powered health, and listen to attendees’ issues and questions.

As usual, when I get out and about, I learn so much, particularly how front-line librarians in hospitals and academic health science centers are increasingly becoming embedded in complex care processes and sophisticated biomedical research. I’m also hearing how often they feel simultaneously essential and invisible.

The librarians I met told stories of team members, months into a collaboration, finally recognizing the person retrieving key literature or managing data was in fact the university’s librarian; or young faculty members who didn’t realize the health science librarian could help locate funding opportunities; or physicians sharing patient-education materials without knowing the hospital library staff developed them.

“Essential and invisible” sums up the state of modern libraries and contemporary librarians—and, to some extent, the state of the National Library of Medicine itself.

As libraries becomes less of a place to go to, librarians are bringing biomedical information to the people they serve, through pop-up libraries, health literacy classes, or targeted emails that deliver expert, preformed searches to the inboxes of busy clinicians.

Similarly, NLM’s resources are becoming untethered from the Library and our website. The entire ClinicalTrials.gov database is embedded in a patient advocacy search engine. MedlinePlus Connect integrates NLM’s patient education materials into electronic health records across the country. And nearly 60 APIs give seamless access to NLM’s carefully curated content, whether that’s peer-reviewed literature, clinical value sets, or standardized drug names.

These shared assets enrich users’ experiences, but do those users know who’s doing the enriching? Probably not.

Essential and invisible.

Of course, it’s great that federal investments into high-quality health information are put to good use—it’s why we exist—but it’s also important that users recognize in the resources they use the high-quality, trusted brand that is NLM. Brand recognition—and the professional expertise behind that brand—contribute to the credibility of the information provided.

So the next time you encounter something helpful for health or biomedical research, take a moment to find out—is it NLM inside?