2015 has begun in style! I have been working on two ongoing projects recently. Medicine Unmasked at Swansea University College of Medicine…
For the former I have been working in the full glare of public light in a small space in the clinical anatomy lab at the college. It has indeed been quite an experience…daunting at first to be so open to all the students and staff who frequented the lab but also very productive in terms of the wonderful dialogue I had – both with the work and with the people! For the latter I am working in my own studio in Cardiff. It is more private – perhaps more intense for that … I am tired but the images seem just to be pouring out of me so fast at present, such that I can hardly keep up with myself.
See more here: http://drawingof.wordpress.com
Another New Year.!..I wish all who read my work a very happy and healthy 2015.
Below is a talk I gave at the Visualising Illness Workshop held at Birkbeck College London last November. It is fundamentally a reflection on the concept behind the Illness begins with “I” exhibition. I hope some of you might enjoy it and, as always , your comments are much appreciated.
I would like to focus in this brief talk on a painting from my recent exhibition entitled Illness begins with I. The painting is called Derma and is a visualisation of the experience of psoriasis, as suffered by someone who is a friend of mine. Bearing in mind Deleuze’s distinction between concepts of philosophy, and affects of art, we can take here both a philosophical, and emotional perspective on the relation between objectivity and subjectivity, and the relation between the ‘Self’ and the ‘Other’, in terms of the image and how it may be interpreted. I believe that any image, whether it be a ‘difficult’ image or not calls the viewer, touches lightly with a soft but insistent evocation of meaning that transcends mere representation. This call can be answered in emotional engagement as the viewer enters a dynamic dialogue with the work, a dialogue that characterises the act and process of interpretation.
Ricoeur approaches an analysis of interpretation through his conception of the hermeneutic arc as a development of the original hermeneutic circle. The arc provides a bridge between the image to be interpreted, and lived experience, where experience is defined in the immediacy of life. This naturally implicates what we understand as the ‘Self’ in the interpretive process, and by consequence, it implicates the process itself as constituting a profound and meaningful interrelation between the Self, the interpreter, and the ‘Other’, the ‘interpreted’, wherein the image, as an autonomous entity, is permitted to ‘speak’ on its own terms.
In this dialogue, the image proposes alternative ways of meaningful understanding from within its own ‘projected world’. This is the world into which the interpreter must step, just as Alice stepped through the Looking Glass, even though some images, especially those of suffering and pain, are difficult to approach. Whilst ever we hesitate to take the step towards true empathy, whilst ever we remain on safe, solid and familiar ground that is sustained by mere, even if well-intentioned sympathy, we only continue to objectify the world of the other and thus avoid the deeply meaningful understanding that is derived from subjective interrelation. Sympathy turns on the gaze, the instant recognition of the image that connects us to the superficial while maintaining our separateness from the fundamental. Empathy however reflects Arendt’s notion of compassion, which defines an immediate sense of another’s suffering that leads to a practical response. As Alan Radley notes in his book, Works of Illness, ‘We do not turn from the depiction as such but from a depiction that exemplifies unbearable suffering’, and thus it is not the image itself that repels us, but rather the deeper understanding of existential suffering that empathic engagement with the image provokes. The risk we take at this level of engagement, by fully entering the world of an image of suffering, is of losing ourselves in a strange and unrecognisable experience of illness and experiencing, in turn, the Other’s sense of horror that accompanies that of abjection.
Radley goes on to note that ill people are indeed part of the Kingdom of the Well, and as Sontag herself acknowledges, they hold dual citizenship, but the sick remain separate in terms of general experience and therefore, according to Ricoeur, the viewer who does step into their world, the world of the Other, must suffer in her own turn the vertiginous disorientating clarity that leads to understanding. Only in this way can a viewer appreciate, or ‘appropriate’, the true meaning of the image, so that it becomes real enough to ‘own’. On encountering the mirror Alice has to move forward and through it in order to get past seeing only the reflection of both herself and her safe and secure surroundings. She can easily describe and explain her own world, the familiar room, the recognisable things that seem to make life meaningful, but beyond the reflection she enters another world wherein the decision to believe or not to believe must be made with ambivalence, and once there, she is no longer, or ever the same.
Meaning then is interpreted by and through the individual, and involves a response not so much to what the image says, but rather to what it says something about, and so, just as my painting is derived from an artistic appropriation that involves my witnessing my friends suffering and ‘owning’ it in the midst of creative process, a viewers interpretation is a further appropriation of the multiplicity of meanings that the image itself embodies, outwith authorial intention. Moreover, and in part through the emotional involvement that it depends upon, such appropriation must eventually give rise to the Deleuzean Figure beyond figuration, the ‘virtual’ figure, the ‘Other’ in relation to which (or who) we all come to realise the meaning – or perhaps yet the meaninglessness – of our own existence. Deleuze and Ricoeur come together, in concept, if not in terminology or even emphasis, at this point where appropriation necessarily precipitates a profound understanding of Self in relation to the Other. For the latter it is the enactment of the concept of ‘re-figuration’, a process of construction, deconstruction and reconstruction of appropriated meaning in the world of the image, that determines the way in which the interpreter comes to understand his or her own being-in-the-world. From a Deleuzean perspective however, it is in a deeper place, in the darkened corners of the your own experience of the image of suffering, and far beyond your individual ego, that you will yourself encounter the ‘Body Without Organs’ or your ‘alter-ego’. The Body without Organs is here the innate and endemic ‘dis-ease’ that we all experience when confronted with suffering, and which is characterised by Ricoeur as the ‘Otherness’ at the very heart of Selfhood. This is the true significance of Illness begins with I
In conclusion, and from my position as an artist, I would like to take respectful issue here with a point made by Radley as he notes, ‘In artistic renderings made by a third party the spectator might be said to sympathise with the painter who has established an asymmetrical relationship with the afflicted person. One outcome of this asymmetry is that the afflicted person is identified with his or her suffering but is not seen to rise above it.’
I am happy to agree with the concept of an asymmetrical relationship that exists between artist and subject, however, I hesitate to follow through with the idea that the outcome of such asymmetry – even from a viewer’s perspective – ever fully denies the identification of the ‘person behind the diagnosis’, and thus the subjects individual capacity to demonstrate resilience and strength of will. The pose for this image was developed from as a composite of several preparatory sketches and photographs. It is intended to evoke a sense of ambivalence such that the sufferer can – and indeed sometimes does – allow himself to be overwhelmed by the condition and let it push him down, or he can – and indeed sometimes does – rise above it and stand up.
I have just returned from Dar Es Salaam in Tanzania where I have been working with the women on the Fistula Ward of CCBRT hospital (Comprehensive Community Based Rehabilitation in Tanzania). I felt very privileged to be accepted as I was, with sketchbook in hand, on the ward.The experience as a whole was challenging and I would go so far as to say life changing. The culture ‘shock’ was so profound that I found myself having to redefine many of my perceptions of what it is to be – let alone what it is to be ill. The project is deeply affective and I and here follows a post from my wordpress blogsite for the Drawing Out Obstetric Fistula project. Please feel free to check it out as there is a lot more information and visual work there about the project as a whole.
Operating across the cultural divide
The theatre clothes are the same but the environment is very different. I feel strange as I enter the operating theatre at CCBRT, a room not unlike those I have been in in the UK but equipped quite differently.
The most obvious difference was the type of operating table. It was shorter than usual and could come apart in the middle so that the patient lay supported only up to the hips with her legs in stirrups. This was a fistula operation.
The first patient is already on the table having had an epidural to numb everything below her waist. She is to be fully conscious throughout the procedure. Her notes show that she has a very small fistula which it is hoped will be easily repaired. She is a young girl barely into her twenties and she has had four deliveries already, all still born. The operation begins after the anaesthetist repositions the table so that the patients head is now lower than her hips. The surgeon inserts a speculum into her vagina and locates the fistula. I am invited to come close and see for myself, and the surgeon explains the procedure to me every step of the way as he gently and carefully cuts around the fistula and brings the tissues over it to cover the opening. The patient remains silent and very still even in spite of the anxiety and fear she may well be feeling. She coughs obediently when asked some way through the procedure.
All is going very well. There are two surgeons now and the nurses attending. Everybody seems to be very pleased as the fistula is repaired and the last is stitch cut off but then, a problem appears, urine is still leaking into the vagina. The two surgeons work quickly and accurately together to find where the second fistula must be. It is deep and there is nothing they can do vaginally. The patient will need a second, abdominal operation.
The second patient walks into the theatre. She looks afraid, confused by the strange surroundings. She is helped onto the operating table and asked to sit up, she is to have an epidural, and injection into the spine. She sits obediently, her face now expressionless. When the needle enters her spine I watch for a reaction, but she doesn’t flinch, her expression doesn’t change at all. She is lain down on her back and her feet are put up into the stirrups. The surgeon goes to talk to her, just a greeting I think and some reassurance. She murmurs a response but does not meet his gaze and on returning to me he lets me know that “they are unused to people talking to them. They don’t know how to react.” I feel that this might be a little harsh considering the situation that the girl is in, semi-naked and strapped to a bed that is so angled that she is virtually upside down. Holding a conversation with anyone, let alone a white man in authority, is clearly the last thing on her mind.
The operation begins and it becomes clear that it is going to be problematic. Once the surgeon inserts the speculum and opens up the vagina to view the extensive scarring in the tissue becomes obvious. This ensures that the fistula, although easily located is difficult to close because of the lack of elasticity in the surrounding tissue. The surgeon works quietly and confidently. Through his years of experience he has developed the impressive precision and delicacy of touch that is obviously necessary in such an operation. There is lots of bleeding and the second surgeon continuously mops it up using the swabs that I saw the women folding just the other day on the ward. They fold hundreds of these light textile squares which are then sterilised for use in the theatre.
The operation continues for a long time but there is never a sound or movement from the patient. Only at the end, when the table is once more flat and the straps are taken off her legs does she ask for water. The surgeon looks tired, it was a difficult operation but he is not unhappy with his work.
There are two more women waiting outside.
In my work on the various projects in medical settings the making of the art, for me, is a creative act that goes beyond documentation. It is an act of empathic witness and the art itself becomes both agent and advocate of patient autonomy through its unique capacity to engage the subjective sensibilities of the viewer. This goes far beyond Alan Radley’s concept of the asymmetric relation – it is a complete immersion of one subjectivity into the world of many others and the results that are derived from such a conflagration serve only to further blur the boundaries between objective rationalism and the passionate human need to co-exist and share experience.
So, for the last two weeks I have been immersed in the culture, and the sheer dynamism of the Oncology Department at Singleton Hospital in Swansea on the first stage of the Medicine Unmasked project. You can find out more about the project and follow its progress here: medicineunmasked.wordpress.com
I have been shadowing four students who are now two weeks into their five-week ‘oncology apprenticeship’ on the Graduate Entry Medical program at Swansea University College of Medicine. Through shadowing, observing, taking notes, engaging in and recording one-to-one conversations with students and medical professionals, and generally getting the feel, from my artist’s perspective, of the students own experiences in terms of learning and teaching of their placement on the department, I have amassed copious notes, sketches and ideas that will all be used as ‘data’ for when I return to the hospital for a further two weeks in January. During this second stage of the project I will work on a body of artwork, drawings inspired by the process as a whole, but until then, and in the meantime, I will offer a series of posts on this blog that relate to the project both directly, as the experiential nature of the project demands, and more theoretically, as the same experiential nature of the project has encouraged! Needless to say I would appreciate any comments/feedback for the posts on this site as all such content potentially impacts on the process of the research as a whole and is therefore very valuable.
“As an experienced doctor you may have seen twenty patients who, say, have had a heart attack. But this patient has only seen one. It’s their first experience so I think that’s what we have to bear in mind.” (2nd year Student)
I want to begin by expressing my deep appreciation and gratitude to everybody I have been working with; the students themselves, the consultant oncologists that are working alongside, specialist nurses, all nurses on the wards, radiologists, staff in the hospital library, in the cafe, and indeed all hospital staff who I have met and who have been so wonderfully accommodating of someone who – let’s face it – must seem a slightly strange presence in the day-to-day dealings of the hospital as I sit quietly and watchfully with sketch-book or dictaphone in hand! I also owe huge thanks of course to the patients who have been so willing to let me be a witness, alongside the professionals and the medical students, to their experiences during consultation, examination and, in one case, of having a ‘shell’ made of his head in preparation for radiotherapy.
As a small group of two boys and two girls, three in their second year and one in her fourth and final year the students have enthusiastically welcomed me into their world as they tackle the demands both professional and personal of working in the department, and in the process my own learning curve has been close to vertical! As much as I have been learning about the student experience both in the specific terms of the apprenticeship model, and in the more general terms of the GEM course as a whole, I have also had the fantastic opportunity to engage with the theory, and most directly the practice of oncology in a way that has had a profound impact on my perception of myself and my practice as an artist working in medicine. It has confirmed, in a very visceral way, that this is the right place for me to be in terms of how I understand my art and what it can do.
Its going to be a fast moving few weeks I think, now the Illness begins with I exhibition is over. It turned out to be a successful show, especially in terms of the generous and sometimes humbling feedback I received. Most importantly for me it validated once again that what I am doing is worthwhile.
Now I am off to Glasgow to meet with my colleague at the University there to discuss my visit next year, and then I am very pleased to be going to Birkbeck College in London where I have been invited to present my work at the Visualising Illness workshop this weekend. http://www.bbk.ac.uk/art-history/research/visualising-illness I will be writing a review of the event on the blogsite for Durham University Centre for Medical Humanities. This by the way is a fantastic resource for anyone interested in the Medical Humanities and well worth a visit.
Finally – at least for now! – In the new year I am delighted to have been invited to give a talk about my work and a masterclass in drawing with cadaveric material with students on the Medical and Forensic Art PG courses at Dundee University http://www.dundee.ac.uk/study/pg/medicalart/
I will be posting on the relevant websites as well as here as these projects develop…I hope you will follow to see how art and medical science continue to interrelate and it perhaps goes without saying that all comments and feedback on the work is greatly appreciated.
Here is the link for a new project that I am beginning with a ‘pilot’ study research visit to Tanzania in December. http://drawingof.wordpress.com/
Entitled Drawing Out Obstetric Fistula: exploring the ramifications of maternal birth trauma through art, the project is intimately related to Drawing Women’s Cancer in terms of the methodology and the primary aims. I am very excited about developing this work and optimistic too about the potential for visual art to cross international, cultural and linguistic borders, especially given language itself is such an important factor in the philosophical framework of all my work that is rooted in the art-medicine relation. You can read more details about this new project by following the link and I hope you will follow the progress of the work on the associated artist’s blog page.
The final preparations are being made and I want pass on here my warmest appreciation for all the support and help I have received from many, many people throughout the preparation for this exhibition. The official opening is on Friday 24th October but over on the Illness begins with ‘I’ page on this site you get a sneak preview of the works and texts that make up the show.
I have just published a new page on this site. It is to become the online home of the Illness begins with “I” art exhibition. There will be a gallery of all of the artwork including some extras along with notes, quotes and narratives that relate to the theme as a whole. I hope you will enjoy the page as it develops and maybe share your thoughts…….