Modest archival collections are vulnerable to decisions born as much out of negligence as ill will. The transmission of certain pasts depends a great deal on chance acts and timely interventions, such as those that have spared from destruction the archives of the American Occupational Therapy Association (AOTA). Fortunately, at opportune moments the organization's often undervalued records fell into hands that respected the small but important slice of history they chronicle.

Located today in Bethesda, Maryland, the archives contains records, publications, letters, and photographs dating to 1917. In that year, individuals interested in the then-emerging field of occupational therapy created its first professional association. The nascent profession drew on elements of moral treatment, psychology, physical rehabilitation, and the 19th-century arts and crafts movement to create a health discipline to care for people with mental and physical disabilities.

Focusing on social causes and interactions, occupational therapy ran counter to emerging Freudian interpretations of mental illness. With its emphasis on integrating body and mind—occupying the patient's attention with meaningful labor—the new treatment methods also deviated from medical norms that were increasingly reliant on the anatomical sciences.

From its earliest days the profession attracted large numbers of women. Many assumed positions of responsibility at a time when few careers called on their skills. Working in the field also allowed women to travel. During World War I, for example, many occupational therapists accompanied the American Expeditionary Force to France, treating soldiers whose bodies and minds had been devastated by the fighting.

Halting attempts to formalize the organization's archives began in the latter half of the 1960s, after the association moved its central office from New York City to Rockville, Maryland. Florence Cromwell, AOTA president from 1967 to 1973, believed the group would be more effective if it were closer to Washington, D.C., the emerging center of power in the medical world. The new Medicare and Medicaid programs were fast making the federal government the nation's largest single purchaser of health care.

"It's a miracle that as much stuff survived as it did," said past AOTA president Bob Bing during a phone interview from his home in Galveston, Texas. A passionate student of occupational therapy's history, Bing wrote as his doctoral dissertation a biography of the association's second president, William Rush Dunton Jr., appreciatively dubbed the "father of occupational therapy."

As the association was vacating its Manhattan office space, Bing said, a staff member noticed secretaries throwing away old files. When confronted, the secretaries said that was what they had been told to do. Revoking the earlier command, association officials ordered the material saved and packed in boxes for the move south. That there was much left to throw out is a small wonder, given the improvised state of recordkeeping in the association's first 60 years.

Early Records Stored in Homes of Association Presidents

The National Society for the Promotion of Occupational Therapy (the original name of the American Occupational Therapy Association) was formed in 1917 at the home of George Edward Barton in Clifton Springs, New York. Barton served for one year as the fledgling organization's first president. He was succeeded by Dunton, who was followed in 1919 by Eleanor Clarke Slagle.

Because there was no central headquarters, successive presidents in the early years kept the group's records and correspondence at their homes. That changed in 1922 when Slagle secured office space with other medical societies in Manhattan's landmark Flatiron Building. According to Bing, she had been keeping the papers in a box in her New York apartment's spacious kitchen.

From the 1920s to the 1960s, the association was housed in a succession of New York offices, Bing said. Every time it moved, "excess" records were discarded. The documents that survived those footloose years were filed with little regard for future access and frequently plundered by staffers hunting for past memoranda.

The earliest attempts at archival organization coincided with the rise of interest in the history of occupational therapy. Cromwell, the president who had moved the organization to Rockville, first voiced the idea of writing a history of the profession in 1966 or 1967, Bing recalled. Cromwell contacted a retired therapist for the job and sent her the boxes of papers. The therapist waded into the archives, such as they were, but was frustrated by their lack of order. That early project to write a history was abandoned.

Cromwell then called Bing, who had a keen interest in the history of occupational therapy. He had recently completed his biography of Dunton and, after his subject's death, oversaw the addition of his personal papers to the AOTA archives. Cromwell wanted to know if Bing would set up a committee to catalog and maintain the archives. Although he had no formal training as an archivist or librarian, he accepted the challenge.

"They were in just a bunch of cardboard boxes and they were a mess," Bing said of the papers that he received. "It was just like stuff great grandma would stuff in the attic." Bing, at the time a professor in the occupational therapy department at the University of Texas Medical Branch in Galveston, set to work organizing the records. When he finished, he sent the collection off to the association's Rockville headquarters.

The AOTA archives committee finally came to life during the presidency of Mae Hightower from 1978 to 1982. She tapped Bing as the committee's chair. The committee decided the best way to preserve the archives was to place them in professional hands. Bing solicited the services of archivists at the Blocker History of Medicine Collection located at the Moody Medical Library in Galveston. He then traveled to Rockville to fetch the collection, where he discovered it languishing in a rented storage unit, his painstaking organizational work scattered to the wind. "It was absolutely appalling," Bing said of his find. "Stuff was flying around all over the place."

Texas Curator Imposed Order on the Ragtag Collection

Blocker archivists received the AOTA records in 1982 and stowed them in the optimal environment for long-term preservation. The library lacked the requisite staff to organize and catalog them until 1984, when Dr. Inci Bowman, curator of the history of medicine collection, volunteered her services.

"We really have to thank the University of Texas and the state of Texas for taking on all that work," said Bing, who feared the archives may have met an untimely end if they hadn't been taken to Galveston.

The highest priority at the time, according to Bing, was listing gaps in the records. When he became AOTA president in 1983, he sought to fill the void by ordering association staff to cull their records in search of missing documents. He then instituted a plan to ensure that current association records were collected for the archives.

Meanwhile, Bowman spent one day a week putting the AOTA archives in order. Her work culminated in a 1987 catalog that is still in use today. "They were very well put together," said Virginia Quiroga, a history professor at Southern Connecticut State University. Quiroga visited the archives while conducting research for Occupational Therapy: The First Thirty Years, 1900 to 1930, published in 1995. "Inci Bowman put together a guide that's very clearly written, very well organized," she added. "It was very easy to find what I needed very quickly."

AOTA staff and members also requested information from the archives stored at Blocker. Many of the requests came over the phone, turning archivists into temporary research assistants for the association, said Bowman. Blocker officials began charging AOTA for use of the archives. Most, though not all, of the collection's users paid when asked. Still, when the library underwent a change in management, officials decided the AOTA archives should be returned to the association's control.

"We wanted to focus our efforts to local archives and the state level collections and not be involved in the care of a national organization's records," Bowman said. The Blocker Collection includes a large set of rare books on the history of medicine. In addition, it holds local records and manuscripts as well as an assortment of hospital postcards and antique medical devices.

In 1992 AOTA held its annual conference in Houston. There, association officials met with Blocker staff to discuss a return of the archives to Bethesda. An agreement was reached, with the association promising to pay for shipping the records to the just-opened Wilma L. West Library of the American Occupational Therapy Foundation (AOTF).

More the object of peripheral attention than benign neglect, today the archives at least has a secure home. Much has been added to the archives since 1992. Sadly, the small AOTF library lacks the means to quickly assimilate the new material, said director Mary Binderman. Currently, AOTF staff are working to secure a grant that will allow them to put the catalog online. Most of the existing resources, however, go to support the immediate demands of the profession as, buffeted by today's turbulent health care industry, it seeks to anchor its role with clinical research.

Still, the profession's past has its partisans. As Bing never tires of saying ("Some people think I have it tattooed on my arm," he jokes), "We live forward but we understand backward."

The archives can be viewed by appointment during regular business hours at the Wilma L. West Library, located in the AOTA building at 4720 Montgomery Lane, Bethesda, Maryland. Call (301) 652-2682, ext. 2557, for additional information.