(edited) Five years ago at Jackson Memorial Hospital in Miami, Trish and Tom Williams gave birth to a 9-pound, 6-ounce daughter named Barbara-Louise.  At first the infant seemed perfectly healthy, but the following day she began having seizures and was rushed to the neonatal intensive care unit of the hospital.  While the anxiety-ridden parents waited, physicians conducted tests to determine what was causing the seizures.

“There doesn't seem to be a thing wrong with her,” one physician explained.  “She's definitely having seizures, lots of them, but we don't know why.  We'll have to conduct more tests.”

That's when Tom Williams, then associate director of the University of Miami School of Medicine library, remembered a conversation among family members that he had overheard years before.  Other relatives had suffered seizures in their infancy.

Immediately he went to the library, sat down at one of the many computers and typed three words in the national MEDLINE search database: “Seizure,” “Family” and “Neonatal.”  (The word “Baby” also would have worked.)

Almost immediately a number of citations appeared on the screen, all about Benign Neonatal Seizure Disorder, or BNSD, a rare but documented genetic syndrome that runs in families.  Williams printed out several articles which explained the condition, its history and treatment.  Typically, it's harmless and disappears within the first year or two in most cases.

Williams hurried back to the physicians and presented his findings, but they weren't convinced.  Williams was.  He withdrew consent for another attempt at a spinal tap.  (Two previous attempts had failed, and the procedure was not risk-free.)

A few days later, the baby's maternal grandfather confirmed that he had traced the disorder in his family as far back as the 17th century.  Little Barbara-Louise's seizures disappeared without treatment after the ninth month.

Today, Williams is director of the University of South Alabama's Biomedical Library.  And the resources that helped his family in Miami are available to the public here, thanks to the combination of Internet technology and the library's growth.

When the USA Biomedical Library was first established in a corner of the already cramped University Library in 1972, it's primary purpose was to help doctors to diagnose and treat patients.  Today, that remains a major need.

“These days, with the everchanging landscape of medical knowledge, it's impossible for most physicians to keep up with it all,” says Dr. William Gardner, Locke Professor and chair of the Department of Pathology at USA's College of Medicine.  “We may scan dozens of medical journals each month, and retain a general awareness, but not the details.

“Then we have a patient with a particular ailment we think, ‘Yes, I read about this in The New England Journal of Medicine a few months back.  There's a new, more successful approach to this.' I can go to the Biomedical Library, and in minutes the staff will track down the article and have a copy in my hands.”

In 1992, the Biomedical Library moved to a newer facility, Alpha North, a former dormitory on the university campus in west Mobile.  The new facility has three times the previous space, and there's a satellite library at University Hospital on Fillingim Street.

The USA Biomedical Library can now provide services for the entire local community.  Through its outreach program, called SouthMed, it serves, for a fee, research needs of non-USA area hospitals, corporations, law firms and medical personnel.

Like many medical school libraries, especially those affiliated with state universities, the USA facility is also open to the public.  And some Mobilians are taking advantage of the opportunity to check out their own ailments and those of friends and relatives.

According to USA Today, during the last two years, The National Library of Medicine's MEDLINE, a database of abstracts from medical journals, has increased from seven million searches annually to more than 180 million a year–and one third of them are done by the public.

Of course, to the uninitiated, setting foot inside a state-of-the-art biomedical library can be intimidating.  The first floor of the USA facility seems relatively familiar–a circulation desk, rows of shelving full of medical texts and bound volumes of medical, psychiatric and related journals.  Computers appear everywhere–many more than in a typical library.

And there are still more on the second floor.  In fact, there's a microcomputer laboratory, a multimedia lab, an instructional lab–and dozens of computers for patrons to use.  What's more, there's a Computer Room, with scores of blinking lights, wires, electronic devices.  The constant hum of the machinery is to a biomedical library what Muzak is to elevators.  This computer room is the brains of the library.  Physicians and other researchers anywhere in the world can use their computers to gain access to the library's research material through the networked computers in this room.

According to library director Williams, whose newborn had the seizures, some of the library's heaviest users rarely come to the facility.

“For many of our patrons, we have become very much a library without walls,” he says.  “In the past, most users went to the reference desk for information.  These days, more often than not, the College of Medicine and Biomedical Library's Homepage on the World Wide Web (http://southmed.usouthal.edu) is the first point of contact.”

The same is true of the university's medical students, local physicians, nurses and physical therapists.  Ordinary citizens may come to the library and sit down at any computer, initiate a search on any of more than 100,000 headings in the database and received an extensive bibliography of professional articles on the subject.  It's even possible, for a fee, to get a printout of an entire article.  Right now, the library has access to the full texts of several hundred medical and related journals, and that number will grow exponentially over the next few years.

To help newcomers–both medical personnel and ordinary citizens–learn how to tap into the overwhelming wealth of information available, librarians at USA Biomedical Library regularly hold classes to teach the use of both traditional library tools and indexes and the more sophisticated electronic equipment.

Despite his own success story, Williams encourages potential users to take advantage of these classes, and to exercise caution.

“We always tell everybody to always check with their physicians,” he said.  “There's so much bogus information on the Web that you can never tell” if a recommended remedy is good medicine or not.  Even the respected medical journals require experience to interpret and use correctly.

“People certainly should never self-diagnose or self-treat,” he said.  “In my case, I went to the doctors and said, ‘This is what I found, what do you think?'  It ‘s important that people know it's always the doctor who makes the final decision.”

The library helps the public in other ways as well.  As Gardner explains, “TV, magazines and newspapers frequently announce medical developments and breakthroughs, and patients are always coming to their doctors with treatments and drugs they want to try.  Usually the information is incomplete, and sometimes dead wrong.  The doctor needs the original research on which the report was based.  That's when he needs the Biomedical Library and its staff.”

But the most important function of the library will always be in helping physicians to make accurate diagnoses and form effective treatment protocols.  “The heart of a medical school is its library,” Gardner says.

Famed cardiologist Dr. Michael E. Debakey puts it this way: “Good information is the best medicine.  Immediate access to current medical research information is as critical as the biopsy and the X-ray have been in the diagnosis and treatment of disease.”

Physically, USA's biomedical library is not as large as most academic libraries–because it doesn't need to be.  Today, thousands of books and journals can be stored not on literally miles of shelves but on Internet sites.  In that respect, Williams says, “We are state of the art in terms of technology, professional expertise and information resources–we need not take a back seat to any of the major academic medical library centers.”
In fact, the new technology now saves not only in the expense of building construction, but also in the cost of having to store and bind many journals.

For more information, call the USA Biomedical Library at 460-7043.InfoFair
The USA Biomedical Library and College of Medicine will hold a technology InfoFair April 12-13, 2000, from 10 a.m. until 6 p.m.  The latest in information technology, medical education, medical technology, telemedicine, distance education, media production services as well as traditional library services will be showcased.