By Nicole Baker ~

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If you’re familiar with A Brief History of NLM, or you’ve followed our series A New History of NLM, you’ve heard of John Shaw Billings, renowned for his vision of a national medical library and for increasing the collection a thousand-fold during his tenure. As a new staff member interested in the history of the National Library of Medicine (NLM), I became very familiar with John Shaw Billings.
I came to know Dr. Robert Fletcher (1823–1912) in a more roundabout fashion. As I was developing a post on tattoos I featured a text from the collection, Tattooing Among Civilized People. The author, it turned out, was more significant to the Library than I had initially realized. Fletcher played a key role in its development in the early years. His contributions are honored in the Library building itself where his face, etched in stone along with Billings and Garrison, greets every visitor who enters.

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In order to better understand Fletcher’s role in the establishment of NLM, I found I needed to revisit how our library came to be. NLM started off as a small collection in the Surgeon-General’s Office in 1836. At the time, this small collection was the only thing resembling a medical library in Washington DC. The library began to grow under Thomas Lawson, the Surgeon General at the time, from 1836 to 1861, until the famous John Shaw Billings was appointed by the Army to care for the collection in 1865. By 1880, the library’s collection had grown so much that an eight-volume author and subject Index-Catalogue needed to be created. And this is where Robert Fletcher played an instrumental part in the development of NLM. Billings said of Fletcher’s work on the Index-Catalogue:
I wish to specially acknowledge the valuable assistance which I have received from Dr. Robert Fletcher in carrying this volume through the press… without which I should have found it impossible to have done the work… the accuracy and typographical excellence of the volumes are largely due to Dr. Fletcher’s careful and skillful supervision.

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To learn more about Fletcher’s life, I started with a Memoir of Robert Fletcher written in 1961 by Estelle Brodman, PhD (herself a towering figure in the Library’s history). It seemed I might not be the only one who is largely unfamiliar with Fletcher’s significant place in the history of the Library. In fact, Brodman stated about her work on the memoir, “With all these years of bibliographic endeavor, it is disappointing that so little direct evidence of what Fletcher did in the Library can now be uncovered.”
Robert Fletcher began his studies at the Royal College of Physicians in 1840. He received his medical certificate in 1846. Fletcher was born in Bristol, England; he emigrated to the United States shortly after completing his studies. He settled with his young family in Cincinnati, Ohio. Shortly thereafter, he lost his second son at only two months of age.

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For the next 20 years he worked in a variety of first civilian and later military positions. In 1850, he decided to end his short-lived medical practice to become a retail and wholesale druggist. Next he tried his hand as “Commission Merchant and Agent for Landreth’s Garden Seeds.” He spent some time as a Medical Purveyor in Nashville at a military hospital until he was pronounced Surgeon, US Volunteers, and Purveyor in 1863. He stayed in that position until 1867. By then, he was 44 years of age and had a family with teenage or adult children.
In a brief hiatus from the Army, Fletcher was employed as Treasurer for Cincinnati Elastic Sponge Co. In 1871, he began five years’ work in the Surgeon General’s Office under Lieutenant Colonel J.H. Baxter, Chief Medical Purveyor. During his time with Colonel Baxter, he assisted in the preparation of a bibliography composed of “5,000,000 sets of figures reduced to more than 5,000 preliminary tables and these further digested into 23 final tables, comprising just over 113,000 ratios… this work was all done by hand” (p.18).
It was this work that made Fletcher an attractive asset to John Shaw Billings, as he envisioned the Index-Catalogue of the Surgeon General’s Library.

On August 31, 1876, Fletcher was ordered to report to the Surgeon General’s Library under John Shaw Billings. Fletcher had spent much of his adult life continually trying new professions, not settling into one career for very long; now, things finally seemed to click into place professionally. From 1876 to the end of his life in 1912, Fletcher served as Principal Assistant Librarian at the Surgeon General’s Library. Fletcher had been greatly impressed with Billings’ work on the Index Medicus catalog for the library and volunteered to assist in compiling and printing the monumental document. Up until World War II, the library changed directors every 3-4 years as an Army posting. Billings left the library in 1895 to become the first director of the New York Public Library. Before he left, Billings hired Fielding Garrison to be an assistant to Fletcher. In the nearly 20 years between Billings retirement and Fletcher’s retirement and eventual death, it was people like Fletcher and Garrison that provided continuity as directors came and went through the history of the library. This continuity provided a stable background for the library’s most important products: the Index-Catalogue and the Index Medicus.

Photograph by Stephen J. Greenberg

Today, the National Library of Medicine is the largest medical library in the world; it’s hard to imagine how Dr. Robert Fletcher would feel about the incredible amount of data that now circulates from the Library. His major project the Index-Catalogue, now just one of many resources offered, has changed significantly from the original 61 bound volumes “…containing millions of bibliographic citations dating from over five centuries…the first systematic attempt to organize the complex world of medical literature into a form searchable by subject, not just by author or title…” to a truly online searchable, downloadable database.
While Fletcher played an integral role in establishing the Index-Catalogue, I can relate to the many public servants, throughout the intervening years and in the modernized digital versions since, that have spent countless hours working to ensure the accuracy of our catalog. I feel fortunate to have played some small part in continuing Fletcher’s legacy by working on database maintenance and other cataloging projects throughout my career.
Nicole Baker is a Reference Librarian in the History of Medicine Division at the National Library of Medicine.
Thank you for this fascinating article! In all my years at NLM I’ve never really looked at the 3 faces in the lobby. And I even spent a year as a volunteer (one day a week) tour guide. They weren’t part of the tour when I did it- maybe they should be! My feeble excuse about ignoring these guys is that I worked for awhile in 38A and then in the basement of 38 so I rarely went through the 38 lobby. I will certainly take a closer look when we’re allowed back on campus.
You’re certainly not the only one! I’ve been working at NLM in HMD since I started as an intern in the summer of 2015, and I don’t recall ever hearing about Fletcher or paying much attention to the carving either. John Shaw Billings was always the name I was told to remember, yet Fletcher stayed at the library for longer. It was eye-opening to learn about him and his contributions! Thank you for reading.