What is distinctive about the visual image as a means of communicating the experience of illness? As an artist working within the field of Medical Humanities this is a question that is very close to my creative heart so naturally I was very pleased to be invited to present at the Visualising Illness event, which took place on the 14th and 15th of November at Birkbeck, University of London, where this and questions like it were addressed by an interesting and eclectic group of artists, clinicians and researchers.
Sponsored by the Birkbeck Centre for the Medical humanities and the Wellcome Trust, the Visualising Illness event was conceived and very well organised by Suzannah Biernoff, Senior Lecturer in the Department of History of Art at Birkbeck, and Fiona Johnstone, final year AHRC funded doctoral student at Birkbeck; a special mention also to Nicola McCartney for her tireless administration. The whole event consisted of a public lecture and panel discussion on Representing Pain and Illness on the Friday evening, followed by the Visualising Illness Workshop that ran all day on Saturday and involved short presentations by all the invited speakers and a plenary discussion. The following is my review of the proceedings, which I hope will be understood as coming from a very subjective, yet fully appreciative perspective.
The Keynes Library in Gordon Square is in a beautiful building that houses the Birkbeck School of Arts. The library itself has been refurbished in honour of John Maynard Keynes who apparently was one of its more distinguished residents. On Friday evening I positioned myself in the audience for the public lecture by the window looking out over the leafy square. The comfort of the surroundings was in stark contrast to the hospital environment where I have recently been working and it made me consider the nature of the boundaries between discussion and an intellectual approach to pain and the illness experience and the actuality of witnessing or experiencing suffering directly. Comfort here is a loaded concept, but that is for another post!
The evening began with the usual welcome and introductions and continued with a presentation by the first Keynote speaker, Professor Joanna Bourke, author of The Story of Pain: from Prayer to Painkillers, who gave a talk entitled Phantom Pain: Amputation and Visualising the Invisible. It was a very interesting presentation, powerfully delivered, in which Bourke defined and wove together two concepts of the phantom, the phantom limb and the phantom surgeon, in a tapestry that explored metaphorical language used to express the sensation of pain. Given my predilection for all things philosophical it is not surprising that certain things resonated with me in the midst of what was a very engaging subject, especially the ‘philosophy of surgical sympathy’ that derived from a discussion of Charles Bell’s delerium, and the concept of imparting sensation to absence in terms of the lost limbs. The talk as a whole made me wonder- and especially in terms of the ‘knowability of the body’- about the concept of amputation and its effects on the psyche. Amputation as we generally understand it involves external forms, limbs etc., however, could the removal of internal structures, as in a hysterectomy for example, be also considered an amputation? There is no doubt that it has similar potentiality for psychological impact, the profound sense of loss, phantom children perhaps?
Next up was a film screening and one of the intentions behind Deborah Padfield’s Duet for Pain is to emphasise a patients experience and perceptions of pain, alongside a discussion of pain outwith a clinical setting. On watching this film for a second time (I first saw it screened at the Narrative Medicine Conference, Kings College London in June 2013) I felt, again, that there was a lot more going on than is possible to verbalise in the conventional way either in or outwith any setting at all. If only for this reason the film certainly makes its point and Alan Radley’s idea that was raised in the following panel discussion, suffering is communicated by being witnessed, is certainly pertinent here.
The workshop on Saturday began with a presentation by keynote speaker Javier Moscoso, Research professor of History and Philosophy of Science, Spanish National Research Council in Madrid, and author of Pain: A Cultural History. His talk, Visualising Diseases, Representing Illnesses was engaging and emotive, especially from a philosophical and art historical perspective, and of all that he said it is his definition of the ‘floating hands’ that figure in many medical representations that was the most resonant for me. There is too much to say in this short post about the implications of Javier’s paper but it certainly made me feel that that his book will be well worth reading!
The rest of the day was very full of complex ideas and complex timing! There were short presentations from two groups (before and after lunch) of six speakers, including myself, where each of us took up the significant challenge of getting across a powerful message in a very limited ten-minute time slot. All of the individual presentations merit of course their own comprehensive review, however space limitation here again ensures that there must be far more that I leave out than I am able to say. I hope those I fail to mention will therefore forgive me. That said, certain things as always come first and foremost to mind. Tom Corby for example gave a moving self-history of his strategy for coping with the onset and continuance of his myeloma, or cancer of the bone marrow. His candid and sometimes self-effacing presentation described his creative process as an artist and writer, which, on diagnosis, he turned towards an expression of his unique experience of illness by collecting and creatively organising all of the clinical data that derives from his ongoing condition. He described the physical, circumstantial and psychological challenges he faces during this process and in doing so gave us a true insight into his resilience and determination in the face of such a challenging situation. This I felt lent deeper significance to the art work itself.
Helen Omand is an art psychotherapist and her presentation about her work with a six-year-old sexual abuse victim was effective of a very sombre mood in the room. The visual content of the child’s artwork, which primarily was about making a ‘mess’ with the various material, including rubbish from the bin, that was to hand was deeply moving and demonstrated that visual language is often more profoundly communicative than words alone. This was borne out later in the day in the presentation by Kristina Page who showed us the artwork of a patient suffering gynaecological cancer.
As a photographer Tim Wainwright presented only two images, however the story that lay, and by his own account uncomfortably, between them was profound. I admired and was inspired by Tim’s undiluted honesty about the search for integrity in his own creative practice. His talk resonated deeply. On a lighter yet no less profound note Rachel Allen’s enthusiasm for her subject was infectious and seemingly boundless. Working as an artist within the clinical setting, and having a deep interest in anatomy, she spoke about the impact of psychological portrayals over physical and how art could address the duality of inside/outside.
After the presentations the whole group separated in order to discuss two distinct questions that the organisers derived from the proceedings. These were:
- How could/should illness be exhibited?
- How might representations of illness inform the clinical encounter or public health?
Of course these are monumental questions, and, as discussed on the day, are really not as distinct as simply separating them out would imply. Each can be approached on many levels, including the most basic level of the terminology that is used and how illness itself is assumed and understood, but nevertheless change and development in any field has to start somewhere. Necessarily these questions require far more than the thirty minutes we had to debate both them and the tangents along which they will inevitably lead, but nevertheless they are at the core of what the weekend as a whole was about and asking them simply serves to define the character of the workshop as a beginning of something that will hopefully continue.