Fiona Johnstone – ISSF Wellcome Postdoctoral Research Fellow and New Generations Programme member reports on the Visual Culture in Medical Humanities workshop:
Recent developments suggest that it might be possible to speak of a ‘visual turn’ within the medical humanities, a field which has, to date, been dominated by the written or spoken word; consider for example the enduring authority of narrative medicine, which has only been subjected to real critical scrutiny in the last few years. Arts-based methodologies have been proposed as one possible alternative to an overemphasis on narrative techniques in healthcare; there has been a renewed interest in art therapy and the arts-in-health movement, in the efficacy of arts-based interventions in clinical settings, and in potential therapeutic and/or diagnostic applications of art and art-making. Several medical schools now run elective modules aimed at developing students’ visual literacy skills through exposure to artworks; in other programmes artists are engaged to teach students ‘soft’ skills such as empathy and communication techniques.
Visual culture – like the medical humanities, a field of practice rather than a distinct discipline – emerged in the late 1980s after art history, anthropology, film studies, linguistics and comparative literature encountered poststructuralist theory and cultural studies. Its development was driven by the apprehension that spectatorship might be as difficult a conceptual problem as reading, and that visual experience might not be fully comprehensible in the model of textuality. Nicholas Mirzoeff (one of the earliest proponents of the new field) identified visual culture as ‘resolutely interdisciplinary’ in the sense given to the term by Roland Barthes:
‘In order to do interdisciplinary work, it is not enough to take a ‘subject’ (a theme) and arrange two or three sciences around it. Interdisciplinary study consists in creating a new object, which belongs to no-one’.
The best work in visual culture – as in the medical humanities – does not proceed from the objects of study – a specific archive, a set of texts or series of images – but from the questions that it asks and the issues that it seeks to address. This work entails ‘uncertainty, risk and arbitrariness’; both visual culture and the medical humanities (still) constitute uncomfortable fields that do not necessarily sit easily within traditional university structures.
Given these compatibilities – interdisciplinarity, an emphasis on research questions rather than objects of study; tolerance of risk and uncertainty – how might a productive relationship between the practices of visual culture and medical humanities be imagined?
This was one addressed by a recent workshop on Visual Culture in Medical Humanities, co-hosted by Durham University’s Centre for Medical Humanities and Centre for Visual Arts and Culture. The opening roundtable ‘What is Visual Culture?’ brought together Suzannah Biernoff (Senior Lecturer in Visual Culture, Birkbeck), Matthew Eddy (Senior Lecturer in Philosophy, Durham), Janet Stewart (Director of Durham’s Centre for Visual Arts and Culture), and Ian Williams (Graphic Medicine / The Bad Doctor); despite the panel’s title, the speakers did not seek to arrive at an authoritative definition of visual culture (which could potentially be described as an academic discipline, an interdisciplinary field, or a specific research strategy). It was agreed that ‘doing’ visual culture is not simply a matter of dealing with visual materials, but involves paying critical attention to vision as a situated practice that is learned rather than innate, and as a discourse which is culturally and historically variable. Janet Stewart referred to Donna Haraway’s 1991 essay ‘The Persistence of Vision’, in which the author challenges the prevailing model of vision as a neutral universal system by drawing attention to its essentially embodied quality, thus revealing the positional politics of sight. The questions that Haraway raises remain significant for any researcher engaged with issues relating to healthcare and wellbeing:
How to see? Where to see from? What limits to vision? What to see for? Whom to see with? Who gets to have more than one point of view? Who gets blinkered? Who wears blinkers? Who interprets the visual field? What other sensory powers do we wish to cultivate besides vision?
The panel agreed that at its most productive, visual culture in the medical humanities should raise searching questions about the social, political, and ethical conditions of visibility and spectatorship; query how certain types of bodies come to be more visible than others; consider how medical identities are visually as well as linguistically constructed; and think critically about the way in which images and objects are used and displayed in (for example) textbooks and research papers, public health campaigns, and medical museums and art galleries.
The two panels that followed were devoted to ‘Medicine and Display’ and ‘Visual Thinking’. Colin Harding from the National Media Museum in Bradford noted that visual artefacts are both naturally interdisciplinary and ontologically unstable; hence researchers sometimes appear unsure of what exactly to do with them. He also drew attention to the current tendency to appropriate art-historical contexts for medical images, thus inadvertently aestheticizing them, and suggested a potentially richer response to visual medical materials might be to use them to drive investigations into the dialogic entanglements of medicine and other academic disciplines. Emma Shepley, curator at the Royal College of Physicians, gave an overview of the college’s collection of medical portraits, Julia Midgley (War, Art and Surgery) talked about her work as an official war artist based in a training reconstruction of Camp Bastion Hospital, and Edward Juler (Wellcome Trust Research Fellow in the History of Art at Edinburgh) discussed the performative qualities of medical identity in relation to a series of photographic self-portraits by the surrealist Andre Breton (who had studied medicine before pursuing a career as an artist).
The artists’ panel proved particularly thought provoking (although that may well be my own disciplinary bias). Deborah Padfield, a visual artist who specialises in lens-based media, collaborates with facial pain specialist Joanna Zakrzewska to explore the potential of images and image-making for enhanced doctor-patient communication. Artist and philosopher Jac Saorsa (Drawing Women’s Cancer) uses portraiture as a framework for conceptual investigations into the experience of illness. Jayne Wilton takes the human breath as the raw material of her research and practice; participants ‘donate’ an exhalation, which is then transformed into a two-dimensional image or three-dimensional sculpture. The panel generated a series of reflections on what special qualities the visual might possess: Padfield referred to the ‘productive ambiguity’ of images, and Saorsa drew attention to the distinctive temporality of the visual, which can create a temporal space more conducive to attention or reflection than the progressive or sequential chronicity of text-based or filmic narratives.
The second interesting point raised by this panel was that the visual is never only visual, but always operates in a matrix of sensory experience. Earlier in the day Maggie O’Neill (Professor of Criminology and Fellow of the Wolfson Research Institute for Health and Wellbeing, Durham) had described her use of visual and arts-based research methodologies for a collaborative project with female asylum seekers, drawing our attention to ‘sensorial encounters’ as one such ‘visual’ methodology. In Padfield’s practice, visual images are used to generate language, often resulting in more personal, richly metaphorical and less clinical patterns of speech; in Wilton’s work sound (the feeling of making a particular type of noise; the relationship between an utterance and its visualisation) plays as significant a role as imagery; both practices involve embodied, experiential encounters as much as visual ones.
A closing panel comprising Ludmilla Jordanova, Angela Woods, Jane Mcnaughton and Janet Stewart provided a moment for reflection on key issues raised over the course of the day. Some of these were presented as observations: e.g. visual culture does not limit itself to the visual but connects the visual with other phenomena; visual culture can draw on an extensive range of theoretical possibilities and philosophical traditions, which represents both a challenge and an opportunity; art can provide an intersubjective space for productive dialogue between artists, clinicians and patients; a consideration of the spatial contexts of creation and display is an important aspect of dealing with artworks and other visual materials. Other issues took the form of open questions: Can the visual sphere allow for a more mobile and dynamic articulation of narrative than the literary one? How is the visual used differently by different disciplines? What is the significance of aesthetics (and how does the meaning attached to this term vary across different disciplines)? It was also observed that a few significant issues could have been more fully addressed during the workshop, including a strong discussion of visual authority and power; an interrogation of questions of visual literacy (is it often assumed that images are self-evident when in fact they are anything but); and a critical consideration of different theoretical models for working with visual materials.
This event was testament to the remarkable variety of practices that might qualify as ‘visual culture’, including fine art practices, comic books and graphic medicine, the aesthetics of illness and injury, the display of medical objects and images, and ‘graphic culture’ (defined by Matthew Eddy as a genre of visual culture that might include objects or practices associated with copying, composing, drawing, tracing, diagrams, sketches, doodles, and so on). My sole criticism is that a richer understanding of the possibilities of visual culture as a tactic for interdisciplinary research might have been achieved by the involvement of a few more speakers from outside the fields of art, art history, and curatorship. This is, I hope, something that will be possible for future events. This Durham workshop was far from exhaustive, merely touching on some of the productive overlaps between visual culture and the medical humanities; judging from the issues raised by this event, the relationship between the two fields will surely merit continued investigation.
 For examples, see Angela Woods, ‘The Limits of Narrative: Provocations for the Medical Humanities’, Med Humanities, 37 (2011), 73–78; and Seamus O’Mahony, ‘Against Narrative Medicine’, Perspectives in Biology and Medicine, 56 (2013), 611–19.
 Woods, p. 76.
 Margaret Dikovitskaya, Visual Culture: The Study of the Visual after the Cultural Turn (Cambridge, Mass.: MIT Press, 2006), p. 1.
 W.T.J. Mitchell, Picture Theory: Essays on Visual and Verbal Representation (Chicago and London: University of Chicago Press, 1994).
 Roland Barthes, ‘Research: The Young’, in The Rustle of Language, trans. by Richard Howard (Oxford: Blackwell, 1986), pp. 69–75 (p. 72); quoted in Nicholas Mirzoeff, ‘What Is Visual Culture’, in An Introduction to Visual Culture (London and New York: Routledge, 1999), pp. 1–34 (p. 4).
 Nicholas Mirzoeff, An Introduction to Visual Culture (London: Routledge, 1999), p. 4.
 Donna Haraway, ‘The Persistence of Vision’, in The Visual Culture Reader, ed. by Nicholas Mirzoeff, second edition (London and New York: Routledge, 1998), pp. 677–84 (pp. 681–2).
 This latter point applies as much to the activity of carrying out and disseminating research as to the specific objects of study. While visual materials are frequently used by scholars from a wide range of disciplinary backgrounds, researchers with little or no training in the formal, theoretical and interpretative modes of visual analysis sometimes risk overlooking the semiotic complexity of the visual (for example, reducing images to mere illustrations of a written argument). See Stephen Caffrey, ‘Privileging the Text, Subordinating the Image’, Reviews in American History, 37 (2009), 521–28.