Becoming an internationalist: reflections on the international activities of Estelle Brodman

Objective: The international consulting and publishing activities of Estelle Brodman, PhD, are placed in the context of Medical Library Association (MLA) international activities. Description: Through multiple consulting engagements in Asia, Dr. Brodman developed an extensive knowledge of the practice and history of health sciences librarianship in countries she visited. International activities in the form of publications, consulting visits, and international meetings occurred sporadically in a career that spanned over forty years and are examined in the context of the international activities of MLA. Method: Selected publications and Dr. Brodman’s oral history transcript were reviewed. Results/Conclusion: Dr. Brodman was a keen observer of the international practice of health sciences librarianship and used her considerable skills in writing and historical research to capture the essence of the cultures she visited. Reports and journal articles form a solid record of scholarship and were complementary to MLA international activities occurring during her career. She approached her assignments with empathy, candor, and respect for the cultures she visited.


INTRODUCTION
Estelle Brodman, PhD, was active in international activities throughout much of her career, although her international legacy is less well known than her achievements in library leadership, automation, education, and medical history. A review of her international activities in the context of the Medical Library Association's (MLA's) international developments through selected publications and her oral history transcript helps round out the portrait of a remarkable individual (Table 1). This article is based on a review of selected publications and Dr. Brodman's oral history transcripts [1]. Archival material including correspondence and reports contained in the Brodman Collection in Columbia University Archives was not consulted. The Brodman Collection covers material from 1950 through 1989 and was gifted to Columbia in 1980 with additions in 1981, 1984, and 1989. The collection at Columbia is described physically by the Columbia University Libraries as ''20 linear ft. (ca. 14,500 items in 46 boxes)'' [2]. Correspondence and other material related to her official duties at Washington University School of Medicine in St. Louis have been retained by the university. The collection notes from the Columbia University archive suggests a broad scope of material, a large portion of which is international correspondence and reports generated by Dr. Brodman or collected by her. Although the Brodman archive was not consulted for this article, it forms a large collection of resources related to her consulting and outreach efforts at the international level and helps establish Dr. Brodman as a significant contributor to international resources beginning in 1962, the year of her first teaching/ consulting trip, through 1976/77, the period of her final consulting trip and report.
During a distinguished health sciences library career, the international contributions of Dr. Brodman overlapped a period of significant international activities in MLA history, a period that provided a philosophically supportive professional environment for her teaching, consulting, and authorship activities. The purpose of this article is to reflect on Dr. Brodman's international activities in the context of MLA's international outreach activities and aspirations and does not attempt to review or evaluate her entire international legacy contained in numerous reports and correspondence. More accessible than the prodigious archival collection at Columbia University Archives are her journal articles and oral history transcripts. The oral history transcripts demonstrate Dr. Brodman's spirit of internationalism, incorporating openness and empathy for the cultures she visited and reflecting her interest in history and teaching.

1947-1957: PROMOTING INTERNATIONALISM
The decade from 1947-1957 was the ''Brodman Decade,'' in which she served as editor of the Bulletin of the Medical Library Association (BMLA). During this period, she changed institutions, moving from Columbia University to the Army Medical Library in Washington, and completed her doctoral dissertation in the history of medicine. The decade was a very fecund period for both Dr. Brodman and MLA in international activities, an era in which MLA policy and organizational structure were established, helping to build bridges to other countries and cultures. The decade included the establishment of MLA's first international committee, establishment of a column devoted to international news and reports in the BMLA, and a commitment by MLA to support the First International Congress on Medical Librarianship in London, July 20-25, 1953.

The Medical Library Association as an international organization
As Ursula H. Poland, AHIP, FMLA, reminded members in her 1982 Janet Doe Lecture, ''Reflections on the Medical Library Association's International Activities,'' MLA began as an international organization when it was founded by four physicians and four medical librarians representing Canada and the United States in 1898 [3]. Although primarily a North American professional organization, MLA never added the term ''American'' to its formal title, although this was considered at one time, as reported by Eileen R. Cunningham in her presidential address in1948.
Our association has always been a very internationally minded group. Years ago, we discussed the idea of adding the word ''American'' to our name. We decided against it because membership was not then, and is not now, limited to any one country. Through the inauguration of our Committee on International and National Cooperation, we have been able to make our contacts and work more specific, and, we hope, more helpful in the international field. [4] It was Cunningham who made international cooperation and outreach an MLA priority through the establishment of the Committee on International and National Cooperation (CINC), later called the International Cooperation Committee (ICC) and, since 1989, the International Cooperation Section (ICS). The first CINC was appointed in 1948 and included Janet Doe as chair with Scott Adams, Sarah Mayer, Eileen Cunningham, and Sanford Larkey as its first members. Cunningham became chair in 1948 and continued in this role until 1955. This was a period of intense activity as many US and international organizations wanted to quickly rebuild and restock  [5]. T. Mark Hodges provided a brief history of the ICS and its predecessor organizations in 1998 [6]. Of particular note is the evolution of the concept of bringing international librarians to the United States for study, one of the key provisions of the original committee. Initially, the Rockefeller Foundation provided funding for this project. When this funding ended in 1960 with a final grant of $24,000 for operation of the fellowship program [6], MLA initially used money bequeathed by Cunningham, until an endowment was raised through the efforts of an ad hoc committee to continue the familiar program.

''News from London''
Dr. Brodman never served as a member or chair of CINC, most likely because Cunningham coveted this assignment and had recently appointed Dr. Brodman editor of the BMLA in 1947, a year before CINC was established. Although never a CINC member, Dr. Brodman created a highly visible demonstration of MLA's interest in internationalism with the BMLA ''News from London'' column in 1953.
It is significant that Cunningham appointed Dr. Brodman a key appointed official of MLA as BMLA editor, because it was Cunningham in the MLA constellation of leaders who had the intense interest in international cooperation and outreach at the time. Dr. Brodman and other MLA leaders would most likely have been influenced by Cunningham's zeal and philosophy regarding the importance of international relations. Dr. Brodman was impressed by Cunningham's ''energy, by her selflessness, and by her sound, pragmatic ideas'' [7]. Dr. Brodman recalled the occasion of her appointment as editor in a brief obituary she wrote for Cunningham in the BMLA.
I remember the day when, as incoming president of the Medical Library Association, she asked me to edit the Bulletin. I was awakened about 6 a.m. from a sound sleep by a phone call from Mrs. Cunningham, who asked me to have breakfast with her in fifteen minutes. I protested; whereupon she said, ''All right-in half an hour I'll meet you at the entrance to the Coffee Shop,'' and hung up. Sleepily dressing and wondering what it was all about, I remember I had trouble getting my clothes on correctly. But in half an hour, I was in the Coffee Shop with all of my buttons matching their button holes, and being asked-directed, really-to become editor. (Incidentally, it was a ten-year stint I enjoyed hugely.) [7] As BMLA editor, Dr. Brodman appointed W. J. Contributions have been secured from other countries: a welcome one is the periodic ''Notes from London,'' while other communications have come not only from numerous British writers but from Japan, Formosa, Australia, Finland, Mexico, Germany, India, the Netherlands, and Switzerland. Through these and through the accounts of our members' activities abroad, our views have widened and our acquaintance with colleagues overseas has become more intimate. [9] During the Brodman Decade at the BMLA, a number of key international papers were published in addition to the ''Notes from London'' column in Dr. Brodman's efforts to make the BMLA more international in scope. Among these was Cunningham's paper evaluating an international cooperation program in 1951 [10] and her guest editorial near the end of the decade, ''Better Medical Libraries throughout the World'' in 1956 [11].
During this decade, Dr. Brodman was active in other international activities, including a paper, ''Education for Medical Librarians in the United States,'' read at the First International Congress on Medical Librarianship in 1953 in London and subsequently published in Libri in 1954 [12]. Her other activities included the publication of a National Library of Medicine guide to Russian medical literature, during the period in which she supervised the Russian translations unit at the National Library of Medicine [13], and a quantitative survey of articles and journals appearing in the medical literature for the International Congress on Scientific Information held in Washington in 1958 [14].

1958-1968: BECOMING AN INTERNATIONALIST
In 1961, Dr. Brodman was appointed director of the Washington University School of Medicine Library. A year later, she accepted her first international teaching and consulting assignment: a trip, funded by the Rockefeller Foundation, to Japan in 1962 as a visiting professor at Keio University in Tokyo. In her oral history transcript, she recalled this as a ''mindenlarging experience'' and suggested that it was on this trip that she became an internationalist.
It was the first place that I had ever been to out of the Western culture, and I lived there long enough to see a good Homan deal of it. I made some very good Japanese friends who took me along to purely Japanese things and whom I've still kept up with. So for me, it was a mind-enlarging experience. I saw things I've not seen before. I got a different perspective on what should be done and what shouldn't be done, on the way in which traditions grow up, all sorts of things that I would never have done. I went there as the ugly American and came back as an internationalist. [1] The 1962 visit to Japan afforded Dr. Brodman the opportunity to visit most Japanese medical libraries, and her observations were published in 1963 in the BMLA [15]. Dr. Brodman was a keen observer, and her article effectively captured the essence of Japanese academic and scholarly culture as she chronicled the development of Japanese medical libraries and provided interesting social commentary to provide context. Her considerable writing skills and interest in history were apparent in this article.
Dr. Brodman's openness to other cultures and their different approaches to various issues were displayed in her oral history comments related to the Japanese visit in 1962.
It was a first time I had ever been in a culture that was not my own. While I made many, many gaffes, I learned a great deal. I learned a great deal about how other cultures do as well or better than we do, and therefore I should not have any chip on my shoulder about how good we were or think that our method of handling problems would fit into a different culture. [1] One of her humorous gaffes was related to bowing properly in the ancient Japanese tradition. Just before she was to give a lecture in the history of medicine to the Japanese Society for the History of Medicine, her interpreter took her aside and told her she would be addressing an important group and that she was not bowing correctly. Dr. Brodman recalls that the interpreter said that ''You're not bowing right and it's a disgrace.'' I was much abashed [laughs]. I went back into the stacks and we practiced bowing. As a woman, of course, I had to bow lower than a man; also, where a woman puts her hands when she's bowing is different from where a man puts his hands when he is bowing. The woman may not stop bowing until the gentlemen and I said ''Well now, how do I know if I'm bowing whether he is continuing?'' She said, ''Well, you have to look up like that.'' When it actually came, I was introduced in Japanese so I didn't understand one word except Dr. Brodman, and when he got through I bowed and he bowed and I kept looking up, and finally I got to thinking about those toys that you give to children with sand on the bottom . . . And I began to giggle and [whispered] that's terrible, that's an awful insult, and I just thought ''If he doesn't stop soon [laughs], I'm going to make a fool of myself!'' But luckily, he did stop. [1] Concluding remarks in Dr. Brodman's BMLA report on Japanese medical libraries suggested hope for the future in that country.
Everywhere I went on my trip I saw some people who were determined to do the best that could be done within the confines of their system, changing what could be changed, modifying what could be modified, and interpreting rules in a way to bring about the desired goals. This makes me leave Japan with hope for the future. [15]

1969-1979: CONSULTING IN INDIA AND THAILAND
A few years after her first international teaching and consulting experience in Japan, Dr. Brodman served as a consultant to the Central Family Planning Council, New Delhi, India, in 1967/68, followed by other consulting assignments in India and Thailand from 1970-1977, sponsored by various organizations ( Table 1). The formal reports from her consulting visits and the material she collected while traveling and teaching forms a significant portion of the Brodman Collection in Columbia University Archives.
When asked during her oral history interview to estimate the value of the consultations in India, she responded that, while she gained from the experience, she did not think those for whom she was consulting gained much at all. I learned a tremendous amount. I don't think they got very much out of it, because my ideas of what they should do were so much beyond what they were capable of doing or had the money to do or the backing of the important political figures to do… I'm not sure that I really did anything except enlarge my understanding of the world. [1] In her Janet Doe Lecture in 1971, Dr. Brodman painted a rather dark picture of new medical libraries in developing nations.
In many countries where medical libraries have just been established, there is nothing on which the society can base a judgment on the value of such institutions. When people are starving, when over a million people in your largest city have no homes, but live on the pavements, when unemployment is causing riots, the needs of new medical libraries must take a back seat. The few such institutions which are set up are not only starved for funds, but their keepers are paid pittances, are of generally marginal education and ability, and are hemmed in with all sorts of restrictions, which make it almost impossible for them to obtain the information needed to bear on the problems of their society. And so, by a sad circle of events, the medical libraries are not very helpful to society, and the society does not place them high on the list of priorities. [16] Dr. Brodman's survey article on worldwide medical libraries published in 1971 was based in part on her consulting trips to India and Southeast Asia and her extensive knowledge of European and American medical libraries, both from an educational and historical point of view. The 1971 survey article is somewhat less interesting than her report on Japanese medical libraries because of the breadth of the material she attempted to cover, although it was very well written and contained interesting anecdotes and historical observations. She suggested in the conclusion that visiting medical libraries in various parts of the world was like ''watching a historical event Honoring Estelle Brodman through personal recollections unfold'' because all libraries are striving for the same goals and going through the same steps to achieve them. ''Yet none of them can be considered to be completely formed and settled-for there lies senility and death-and all can learn from each other. In that sense, indeed, medical librarianship is 'one world''' [17].

1980-2008: INTERNATIONALISM AT THE MEDICAL LIBRARY ASSOCIATION
Dr. Brodman's international activities from 1947 through 1977 included transforming the BMLA into an international journal, through solicitation of international contributions and establishment of the ''News from London'' column, and significant consulting and teaching trips to Japan, India, and Southeast Asia, including reports and publications related to these visits. These activities suggested a deep commitment to international cooperation and understanding that helped support the spirit of internationalism in MLA. Although Dr. Brodman retired from Washington University in 1981, the decades following her retirement included a continuation of the spirit of internationalism through adoption of important policy and strategic direction, including bilateral agreements, international policy statements, and creation of the ''Librarians without Borders'' global partnerships and initiatives program in 2007.
Poland traced the history of MLA's international program in her 1990 BMLA commentary and captured the richness of these programs and contributions by MLA to international cooperation [18]. Her report included a description of a 1989 report adopted by the MLA Board, the ''International Affairs-Policies'' [19], which recommended policy statements that were intended to form an integrated management structure for MLA's international activities to replace ad hoc decision making. Among the policy statements reflecting MLA programs at the time was one related to bilateral agreements, a program initiated in 1980.
The adoption of bilateral agreements between national associations added a different dimension to the MLA approach to international relations. MLA President Frances Groen, FMLA, explained the need for bilateral agreements in a guest editorial in the BMLA in 1980 [20]. While cooperation between Canadian and US medical librarians had existed since the founding of MLA in 1898, it was not until 1976 that a trans-Canada association of health sciences librarians was formed, called the Canadian Health Libraries Association/Association des bibliothéques de la santé du Canada. It was the need to recognize a mutual agreement between two equal participants that guided the new policy of bilateral arrangements observed today by MLA.
In 1989, the ICC became the ICS, which allowed many MLA members to pursue international interests of various kinds through participation in the section and replaced the more restricted and limited partic-ipation committee structure of the ICC involving far fewer members.
MLA continues to evolve as an international organization. The most recent contribution to this evolution was the report and recommendations of the MLA Task Force on Global Initiatives in 2005 [21], the adoption of a strategic statement regarding international relations, and the creation of the ''Librarians without Borders'' as a branded program supporting the most recent changes [22].
The new MLA international strategic statement underscores the importance of partnerships and the need to build in-country capacity through qualified librarians, technology, and information access.
MLA believes that key elements in improved health for all peoples are the ability of each nation to strengthen and build health sciences information capacity through qualified health sciences librarians, implementation of supporting technological infrastructure, and access to quality information.
MLA supports capacity building programs at the association, section, chapter, and individual member areas.
MLA believes that building capacity will be most effective and long-lasting when partnerships are created with groups sharing similar goals, particularly partnerships with international agencies where shared goals intersect with available expertise and infrastructure. [23] Current MLA activities focus on the ongoing interest in and evolving strategy of international relations initially articulated by Cunningham in 1948, modified by subsequent MLA actions, and supported and enabled by MLA organizational units and committed individuals such as Dr. Brodman. Dr. Brodman's international teaching and consulting in the 1960s and 1970s, supported by a variety of international organizations, and her approach to these assignments were complementary to MLA initiatives during that period and appear to be highly consistent with the strategy MLA has recently adopted.

CONCLUSION
At the time of her retirement from Washington University in St. Louis, Dr. Brodman listed three ''present interests'' in her curriculum vitae. These topics had persisted throughout a long and distinguished career. 1. Impacts of new technologies on methods by which scientists gather information and inspiration for research and teaching, and the relationship of the library as a communication center for this. 2. Philosophical and social bases of the education of information specialists to the scientific field. 3. Medical history, with especial reference to its importance both to those who will pursue this study professionally and to those to whom it will only broaden insight into scientific methods. [24] Missing from the 1982 interest list is a stated interest in international cooperation or international relations. Given her extensive international consulting and scholarly contributions in this area, the absence of Homan interest in the international arena may seem odd at first. Her oral history provides some clues.
When asked how she became involved in consulting at the international level during her oral history interview, Dr. Brodman answered with a chuckle, ''Well, your guess is as good as mine'' [1]. She recalled being at a meeting at the New York Academy of Medicine when officials from the China Medical Board attending the same meeting approached her about evaluating Japanese medical libraries, which they had been funding, and inquired about her interest in training Japanese librarians.* The subsequent survey of Japanese medical libraries and teaching at Keio University in 1962 intersected a number of her interests, in particular history and teaching. It most likely was not the international consulting that turned her on, but the intersection of teaching, history, and international consulting. When she received a telephone call from the United Nations asking her if she would be willing to go to New Delhi for six months to be a consultant to the Central Family Planning Institute, she inquired, ''Who in India knows I even exist?'' [1]. One has to wonder if international interests were ever on her ''present interests'' list.
These examples illustrate an opportunistic approach to international work rather than something planned. Dr. Brodman became an international consultant not by consciously seeking such a role, but by accepting an assignment when opportunity knocked. When she did accept an assignment, published reports and her oral history suggested that she wholeheartedly embraced the foreign cultures in which she visited, observed, and taught with respect, candor, and empathy. She was also aware of the limitations a foreigner brings to a consulting assignment. In her concluding remarks in the BMLA report on her 1962 Japanese trip, she noted: A surveyor always brings to the field being surveyed his own culture, prejudices, beliefs, and backgrounds and, being unable to discard them, can only hope that he is aware of this fact when making his survey. [15] International assignments often intersected her primary interests of history, teaching, and scientific communication. To some degree international consulting would have been expected of her by her distinguished mentors among MLA leadership, including Doe and Cunningham, and by the internationalist culture present during her first twenty years as a member of MLA. However, in attempting to fulfill the international outreach aspirations and expectations of her MLA generation, Dr. Brodman became a true internationalist whose example of service can still inspire today.