CRAIG T. KOJIMA / CKOJIMA@STARBULLETIN.COM The library doubles as a museum with displays of ancient medical and surgical techniques. John Breinich, the library's executive director, above, recently looked over a skull that had a hole sawed in it to relieve pressure from headaches.

Isle medical library
is a trove of answers

Doctors, students and the public
find help in an unrivaled archive
that spans centuries

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By Helen Altonn
haltonn@starbulletin.com

The woman's unborn child was diagnosed with Klinefelter's syndrome, a condition in which males are born with an extra chromosome.

She had never heard of it, so she turned to the Hawaii Medical Library for information that helped her decide whether to continue the pregnancy.

"Today, I have a healthy 2 1/2-year-old. I know what to expect, to watch for, thanks to the information from the library," she said in a survey of the library's patrons.

Others said they received information that calmed their fears before surgery, described warning signs about a certain condition and helped to better understand an infection and course of treatment.

"Provided me with information that doctors either didn't have or did not have time to explain," said one library user. "Helped me to suggest possible alternatives to medications which did not suit me. Helped me to ask questions and give info that helped doctor with diagnosis and treatment for me."

The private, nonprofit library, which a few doctors began with personal collections in 1913, now houses the largest collection of medical publications and materials in the state.

"We are a state treasure," said Alice Witkowski, head of the library's public services.

"Instead of buying books on medicine, I save a lot of money; I borrow them," said Malia Haleakala of Maui, third-year University of Hawaii medical student searching recently for material on psychiatry. "I use the online system a lot."

"There are no medical journals at the UH library," said Barry Mizuo of Oahu, also a third-year medical student. "This is a real big plus."

Executive Director John Breinich said the library began in a bungalow on the Iolani Palace grounds and moved into the State Library when it opened. Outgrowing facilities there within two years, it moved to various places in the Queen's Medical Center.

The Honolulu County Medical Society took it over in 1941 and gave it its first permanent home in the Mabel Smyth building. In 1962 it became part of Queen's, which provided land for a three-story library next to the medical center at 1221 Punchbowl St.

When the John A. Burns Medical School began in 1974, the library expanded to meet its needs, Breinich said.

"There wouldn't be a medical school without this library," Witkowski said. It has more than 80,000 volumes of books and thousands of photographs, journals, models, charts and teaching materials, videos, tapes and CD-ROMs.

Doctors and hospital personnel can obtain immediate up-to-date information through extensive online resources.

Its Web page receives 3 million hits a year from all over the world, with wide interest in Hawaii's historical records, Breinich said. "We have unique material. All medical information from the Pearl Harbor attack is posted on the Web page, with reminiscences of physicians' diaries in service that day."

Biographies of all physicians who ever practiced in Hawaii and more than 5,000 photos of doctors are archived in the library and used for family genealogies.

The library doubles as a museum with displays of ancient medical instruments and surgical techniques, such as a skull with a hole sawed into it to relieve pressure and headaches. "It goes back to caveman times," Breinich said.

The "History of Medicine" is contained in a collection donated by the late Dr. Charles S. Judd Jr. The oldest book is dated 1555.

This and other collections of rare books, photographs, medical instruments, records and personal papers make up the Mamiya Medical Heritage Center, established at the library in 1999 by Dr. Richard T. Mamiya.

Besides Queen's and the medical school, the library has contracts to serve other hospitals, Kapiolani Community College, Hawaii Pacific University, the state Health Department, state library system, Hawaii Medical Association, other institutions, corporations and law firms.

Faculty, students and employees of facilities under contract are eligible to use the print and electronic resources and borrow books and materials for educational displays or health fairs.

"I think our impact is much broader and deeper than it may first appear," Breinich commented, noting people seek information for grants, clinical trials or a business venture.

"Anyone can come into the library, use the service, take a book off the shelf and make a photocopy," Witkowski said. The public is welcome.

Not only patients, but families visit or call the library, wanting to know more about a condition or medical tests, said Tina Okamoto, who heads the library's Consumer Health Information Service.

Consumer services are funded through an anonymous foundation five-year grant in its last year, Breinich said. "We're looking for ways to continue services to the public. ...

"Patients are taking a more active role in their health. We want to make sure they're getting as much reliable information as possible so they can fully participate in decisions."

Health issues of most concern, according to the library, are alternative medicine, back pain, breast and colon cancer, depression, diabetes, drugs, hepatitis C, hip replacement, osteoarthritis, diet and nutrition, and stroke.

One database is devoted to authoritative information and sources on alternative and complementary medicine because it is a "hot topic," Okamoto said. Information sites and links also are listed for the latest Hawaii health issues: environmental molds, typhus, West Nile virus and hormone replacement therapy.

Customized information packets are provided for consumers, and they can access an "Ask-A-Librarian" online service with questions or consult reference librarians.

But the librarians emphasize they do not practice medicine. "We don't diagnose," Witkowski said. "We give information, and the doctors can interpret how it applies to them."

Hawaii Medical Library >> Status: Member of the National Network of Libraries of Medicine, founded by the National Library of Medicine. Designated Resource Library for Hawaii and the Pacific Basin. >> Hours: Open 7:30 a.m.-10 p.m. Monday through Thursday, 7:30 a.m.-8:30 p.m. Friday, 9 a.m.-5 p.m. Saturday and 10 a.m.-6 p.m. Sunday. >> Collections: More than 80,000 bound volumes of books and journals, 1,000 current print and electronic periodicals, 5,000 photographs, 1,700 video and audiotapes and 17,000 microfiche. >> Memberships: Services are provided through institutional, personal and special memberships. Consumers can obtain a Consumer Health Information Service membership for $25 per year. Nonmembers and the public may see exhibits, use consumer materials and photocopy machines on the main floor at no cost. >> Web site: hml.org >> Phone: 536-9302