XXI

The Library's Program for Awarding Grants

F

MARTIN MARC Cummings, DIRECTOR 1964—

OLLOWING the resignation of Frank Bradway Rogers from the directorship on August 31, 1963, Surgeon General Luther Terry asked Scott Adams to accept the post of Acting Director and to sit on a committee to nominate a new Director.' The committee, chaired by James Hundley of the PHS, considered nine persons from within the service and 19 from without. It finally selected Martin Marc Cummings, chief, Office of International Research and associate director for research grants, NIH. Terry appointed Cummings as the new Director of the Library. After accepting the post Cummings remained at NIH finishing his work while spending considerable time at the Library overseeing the final stages of the MEDLARS publication system. He became Director officially on January 1, 1964.

Cummings was born in Camden, New Jersey, on September 7, 1920. He received his B.S. degree from Bucknell in 1941 and M.D. degree from Duke in 1944. At Duke he became interested in diseases of the chest, particularly tuberculosis. This led him to accept a Public Health Service internship. He was assigned to the Boston Marine Hospital where, during his second year, he received a commission in the service and was placed in charge of the Tuberculosis Section.

In 1946 the PHS provided Cummings with specialized training in bacteriology and tuberculosis at the Michigan State Health Department, and overseas at the State Serum Institute of Denmark. It then assigned him to the Communicable Disease Center, Atlanta, to establish a tuberculosis research laboratory. At the neighboring Lawson Veterans Administration Hospital he had the opportunity to treat tuberculosis in veterans, and in 1949 he joined the staff to head the Tuberculosis Service and organize a laboratory for tuberculosis studies. Concurrently he taught medicine at Emory University School of Medicine.

The Veterans Administration asked Cummings to move to Washington in 1953 to become director of research services. Concurrently he lectured on microbiology at George Washington University School of Medicine. He also represented the Veterans Administration in meetings of the National Advisory

Health Council and thus became acquainted firsthand with the operations and administrators of the National Institutes of Health.

Wishing to return to research, in 1959 Cummings accepted the position of professor and chairman of the department of microbiology at University of Oklahoma. With assistance with grants from NIH he upgraded the department, but before long was lured back to Washington by James Shannon, Director of NIH, to head NIH's Office of International Research

Upon assuming the directorship of the Library, Cummings moved rapidly to improve the scientific quality of MEDLARS, and have the recently developed computerized bibliographic system utilized and evaluated nationally and internationally. He began to broaden the Library's mission. Within a few years he obtained legislation for a grants program, inaugurated a research and development program, obtained authorization for a new building, organized a toxicology information program, directed the acquisition of a medical audiovisual organization, changed the Library's role in continuing education from passive to active, and encouraged broadening of the mission of the History of Medicine Division. He attracted experienced, intelligent and energetic associates to manage the new programs. He was successful in his relationships with his superiors in higher echelons of the Department and in the legislative branch, who respected his leadership of the Library. He served as Director of the Library longer than anyone other than his hero, John Shaw Billings.

Cummings' work in the Public Health Service, Veterans Administration, and University of Oklahoma was reflected in 68 articles and chapters he wrote

on tuberculosis, sarcoidosis, microbiological technique, and other medical topics. He also coauthored a text, Diagnostic and Experimental Methods in Tuberculosis. From the National Library of Medicine he wrote on a variety of subjects, including NLM programs, library operations, biomedical communications, history, and administration.

Among the honors bestowed on Cummings for leadership in library affairs were six university degrees, the Superior and Distinguished Service awards of the Department of Health, Education and Welfare, the Distinguished Service Award of the College of Cardiology, an honorary fellowship in the College of Physicians of Philadelphia, an honorary membership in the Academy of Medicine of the Institute of Chile, and the Rockefeller Public Service Award, the most prestigious recognition that a Federal civil servant could receive.

BEGINNING OF THE GRANTS PROGRAM

It was inevitable that the Library would become involved with grants after it became a part of the Public Health Service and closely associated with the National Institutes of Health. The NIH had begun to award grants to assist research with a tiny sum of money in 1938. After World War II Congress increased the funds astronomically, from less than $1 million in 1946 to $63 million in 1956 to $177 million in 1958. Every institute in NIH awarded grants for stimulating and supporting research in its area.

In 1959 the Library's Board of Regents learned that NIH was considering granting funds to two medical schools for the purpose of training librarians. During the Board's first meeting in 1960 Michael De Bakey, Surgeon General Leroy Burney, Director Rogers, and other members discussed the possibility of NLM's awarding grants for training librarians, research in history of medicine, preparing special bibliographic reviews, and other purposes. Rogers then decided to have plans drawn up for a program under which NLM would assist other medical libraries to improve their facilities and services.2

In the summer of 1960 Rogers asked the General Counsel of the Department of Health, Education, and Welfare if the Public Health Service Act permitted the Library to award grants. 3 The counsel ruled that the act did not, and Rogers started on the long road that would lead to authority and funds. He had been looking for a person to become deputy director to assist with the management of the current work; now he also needed the deputy to plan "extramural" activities. He brought Scott Adams back from the National Science Foundation to the Library in this position, and assigned Estelle Brodman as Adams' associate. After Brodman resigned in 1962 to become librarian of Washington University Medical School, Daniel Bailey assisted Adams.

While facilities for medical research, education, and health care had been greatly expanded and improved since the mid-1940's, most medical libraries had been ignored by the schools and institutions they served. Federally sponsored research in the Veterans Administration, National Institutes of Health, universities, and institutions had created a continuing overload on libraries in

the 1950's. Libraries had not had sufficient funds to acquire, process, and store the large amount of books and journals wanted by users. Libraries had not been planned with sufficient storage space. Many were overcrowded, and some had had to store publications in warehouses, whence it took hours for retrieval. There was a shortage of professional medical librarians. Relatively few libraries were able to serve efficiently and rapidly as conduits for the transmission of information between researcher and applier. A Senate document in 1960 reported that all medical schools needed urgently an "improvement of their libraries, which are essential to the functions of education, research, and good medical care."5

Adams and Brodman had no difficulty in identifying deficiencies in libraries. They outlined a program to support traditional publication media (journals, reviews, and translations), to assist abstracting and indexing services, to further the training of medical librarians, and to strengthen the facilities, resources, and services of medical libraries through which information was made available locally to researchers. They also proposed support of investigations into the principles on which new and improved systems of communication might be built. To accomplish these goals, they drafted programs in the areas of publications and translation; fellowships, library facilities and resources; education and training; and research and development. The Board of Regents approved the scope of the program in November 1960, and a request for funds was included in the preliminary budget for fiscal year 1963.6

Adams and Brodman continued to compile information to reinforce the Library's request that it be given authority and funds to assist other medical libraries. They wrote reports and articles, and Brodman arranged a contract with Harold Bloomquist of Harvard Medical School to survey medical libraries and to describe what improvements were needed.7

TRANSLATIONS

In the meantime events at the National Institutes of Health resulted in the transfer of a small grants program to the Library. In July 1956, directed by the Senate Committee on Appropriations to make “available to American scientists the full findings of Russian scientists," the National Institutes of Health in cooperation with the National Science Foundation set up the Russian Scientific Translation Program. Scott Adams, librarian of NIH at the time, directed the program under which Russian medical and related publications were translated, reviewed, and abstracted in English. The work was done in Poland and Israel, some of it financed by grants and contracts, some by funds available through Public Law 480, the Agriculture Trade Development and Assistance Act of 1954, amended in 1958. Under this law foreign currencies that accrued to the credit of the United States from the sales of surplus agricultural commodities could be used to "collect, collate, translate, abstract, and disseminate scientific and technological information."

Adams left the NIH library in 1959 to take charge of the National Science

Foundation's foreign science information program. His departure led to a debate by NIH, PHS, and NLM about the future of the Russian scientific translation program. The portion of the program financed by Public Law 480 funds was transferred to the Library in August 1959; the portion paid for by grants was retained by NIH with the expectation of transferring it when the Library moved to its new building in Bethesda. But before the move took place the transfer was made on July 1, 1961, even though the Library did not have legislative authority to make grants." Director Rogers felt that the use of grants to finance translations was not proper, and in 1962 he directed that they be replaced by contracts.

PROGRESS TOWARD A LAW

The grants for translation had no effect on the efforts to obtain authority. Adams and Brodman drafted and redrafted specifications for legislation, and compiled supporting documents. Surgeon General Luther Terry, a member of the Board of Regents and a supporter of the program, approved the specifications, but then there arose in his office a disagreement over the scope of the PHS's mission in medical communications. Legislation needed by the Library could not be written until Terry's staff felt they were on firm ground. Furthermore, it appeared that some of the Library's proposed plans might duplicate or impinge on missions of other organizations within the service. The National Institutes of Health, in particular, was entering the field of science communication and might limit the Library's activities. To obtain the views and ideas of all the organizations in the service on communications, the Surgeon General convened a conference on the subject. Finally Terry's staff defined the activities in which the PHS could engage. They drew a line between the work of NLM and NIH and pointed out the areas in which the Library could give grants under authority of the Public Health Service law. On March 29, 1963, Terry delegated authority to the Library to support training, research fellowships, and research grants. 10 But the Surgeon General's staff was still not completely satisfied about the limits of the authority that the service, and thus the Library, possessed to give grants in the field of medical communication. At last the Secretary of HEW asked the Comptroller General of the United States for his interpretation. On March 4, 1964, the Comptroller ruled that the PHS law permitted the Surgeon General to delegate authority to the Library to make grants for activities relating to the communication of results of medical research. 11

In the meantime Rogers had retired and been succeeded by Martin Cummings, who believed strongly in a grants program. In January 1964 Cummings and Surgeon General Terry talked with Senator Lister Hill about their hope of gaining such a program for NLM. Senator Hill liked the concept and asked Cummings to have specifications drafted for the legislation. Two months later, following the Comptroller's decision, Cummings began to mobilize a staff to develop and manage a full grants program. He recruited Marjorie Wilson from