Guest Piece: Joseph Ting: “Medicine Now, at the Wellcome Collection London: Obesity, The Body, Malaria and Genomes”.

Medicine Now, a permanent exhibition at the Wellcome Collection in London, presents a range of ideas about science and medicine since Sir Henry Wellcome’s death in 1936. Designed to broaden engagement with medical science beyond the narrow confines of the laboratory or clinic, Medicine Now presents a cogent multidisciplinary view of four topics, Obesity, The Body, Malaria and Genomes. These are explored through the perspective of patients, doctors, scientists and artists.

 

Medicine Now ranges over contemporary art, the way medicine has been perceived, and has affected the human race, in the last eighty years. The intersection between art, science and medicine is made accessible to the lay audience and there are challenging displays for the specialist visitor.

 

Obesity

Dieting, weight consciousness, anxiety about body weight and shape and widespread hostilty to obesity are fundamental themes in contemporary life. There is tension between modern populations trying to control their weight amid unprecedented opportunities to let themselves go. [1]  John Isaacs’ two metre high “I can’t help the way I feel” (2003) comprise superhuman sized globules of cellulite perched on tiny legs (Fig 1).

 

This corporeal aggregate of multilobulated fat has submerged its own head, preserving its anonymity. This however has the unfair effect of diverting the viewer’s attention to the grotesquerie emanating from below the neck. A strategic overgrowth of fleshy apron over the thighs conceals the gender of the person portrayed by “I can’t help the way I feel.” Isaacs may be commenting on society’s fixation with the female form, despite obesity afflicting both sexes.

 

I can’t help the way I feel” could be considered the ugly embodiment of the obesity epidemic. The attention-grabbing dimpled thighs, soft bulges and doughy rolls of Isaacs’ sculpture reminds one of the difficulty the obese face in trying to not draw attention to themselves. The artist’s sympathetic contention that “the way in which the flesh grows, erupts and engulfs the body can be seen as a metaphor of the way in which we become incapacitated by the emotional landscape in which we live and over which we have little control” did little to temper my repulsion for “I can’t help the way I feel.” The impulse to ridicule, discriminate against, and publicly monitor the body shape of, the obese has its basis in the visible markers of fatness (wide hips, protruding belly, vast thighs) transgressing aesthetic standards and signalling pathology and disease. [1] My seeing fatness led to the negative reading of fat bodies. More than ever, judgements about our own and others’ worth is based on the morphological body as compared to the ideal.

 

The Body [Figure 1]

Anthony Gormley, a commentator for Modern Medicine, claims “the body (to be) the root of all our experience, a place where we all live and on which our consciousness depends.” The Body examines new techniques and ways of looking at our internal biological structures and function.

 

Medical imaging technologies play a crucial role in comtemporary medical care.  A century after Wilheim Rontgen discovered x rays, the human body is accessible to radiological techniques that enable doctors to peer inside the intact human body. To improve understanding of new technology, the visitor can sit on sound chairs to hear the views of a Professor of Medical Physics on CT scans and an ultrasonographer on antenatal ultrasound.

 

Anatomical objects-dissected bodies and constructed models-have aroused the interest and curiosity of lay audiences since the late fifteeth century. [2]I found the coronally-sectioned plastinated body of a standing human cadaver confronting. Michel Foucault’s vivid description of “externalising the internal” remains deeply disturbing when one imagines plastinated transparency forcing the total detachment of the body’s interior from an identifiable and skin-covered person. The sliced body brings to mind Gunther von Hagens’ Bodyworlds blockbuster that travelled the world and attracted millions of visitors. Then there was outcry protesting the moral ambiguity surrounding the display of artfully dissected human bodies for mass entertainment.  However it is hard to deny the educational value of Transparent Woman (1980), from the Stiflung Deutsches Hygiene-Museum, which allow the visitor to light up several human organs with a push button panel.

 

Moral objections are harder to pose with the Visible Human Project. Digitised anatomical bodies are developed from thin CT cross-sections of a standard adult male and female body, offering perpetual electronic cadavers that are able to be logged onto regardless of time or location, and facilitating the training of students and surgeons. Digital simulation comprise unmediated inscriptions of cadavers that have not been distorted by the pencil of the illustrator or the knife of the dissector. 2 However, unless the electronic form can be sculpted into a model by 3D bioprinting, tactile cues remain impossible.

 

The audio observations of a humanities academic seeing medical students performing anatomical dissection for the first time was most poignant as the heart was delivered into cupped hands. It brought back memories of my own tentative first encounter with our dissection group’s cadaver in the anatomy laboratory. However, The Body pays scant attention to human physiology. The finger sensor that was supposed to measure my pulse and cardiac rhythm and display this “biogram” on a touch screen failed to work. The pulse oximeter is not a new innovation, having been around for decades.

 

Malaria

The mosquitoes used by Alastair Mackie to outline the world’s coasts on a plain white board in Mosquito Coast (2002) come from the malaria research laboratory at the Division of Cell and Molecular Biology at Imperial College London (Fig 2). The fragility of thin borders formed by a delicately assembled line of single mosquitoes belies the difficulty humans have encountered since antiquity in trying to overcome malaria’s formidable defences and superb adaptation. Mosquito Coast testifies to an army of malaria-bearing mosquitos encircling land masses and islands to symbolically entrap the world.

 

At the dawn of the twenty-first century, Mackie’s map puts us on notice that the malarial mosquito loaded with its most feared pathogen still commands worldwide attention. Each year millions of people die from malaria. Over vast regions, human health continues to suffer and national economies fail. Although malaria is a potent threat only in the tropics, it remains a disease without borders, with sporadic cases occuring in returning travellers and immigrants in advanced nations. The absence of national boundaries in Mosquito Coast signify the porous permeability of malaria’s distribution. Where it had not been reported previously, de novo malaria now occurs ocassionally in northern Australia. [3]

 

Mosquito Coast  forces the recognition that malarial mosquitos remain a robust and ancient foe that continues to shape human history worldwide. Opportunities for malaria spread around the world occur with increasing international travel and trade. Mosquitoes survive transoceanic flights in aircraft cabins and baggage compartments and are brought to distant ports in shipping containers. [4]

 

Mosquito Coast stimulates thinking on the the role of global climate change, congested urbanisation and environmental degradation in expanding the habitat of malaria-armed mosquitoes. We are reminded of the disrupting effects of human activity on the ecology of pathogen carrying vectors. However it is not all bad news. Mackie’s world map reminded me of satellite-aided Geographical Information Systems that employ meterological data and malaria incidence tracking to better  deliver insecticides and antimalarial. The global reference implied in Mosquito Coast urges international research to control malaria and its mosquito vectors to be as collaborative as the tightly linked mosquitoes on show.

 

Genomes examines the scientific study of DNA as well as its social and cultural significance. The scale of the challenge faced by the Human Genome Project is mirrored in the formidable series of books containing the first printout of whole human genome, presented at reduced font to to able to accommodate 3.4 billion units of DNA code, and neatly arranged on high shelves. High tech gene sequencing is complemented by television documentaries dealing with the human suffering inflicted by a mysterious familial disease, the genetic mechanisms of which were not known then. Even when the diagnosis of a range of genetic diseases is now possible, the prospects of replacing defective genes with curative intent remains a distant dream.

 

Conclusion

 

Modern Medicine more than fulfills the Wellcome Collection’s modest aim to being a “free destination for the incurably curious.” The exhibition is capable of inciting public interest in the performance of medicine in its more recent incarnations. In exploring the connections between modern medicine, life and contemporary art, visitors can achieve intriguing insights that result from the intersections between past with present; professional and lay; science, art, and society. Obesity and Body is analogous  to “looking and being looked at [judging body weight and aesthetics], and looking through [medical imaging and anatomical models]” respectively. Genome and the (plastinated) Body displays pose difficult moral and ethical challenges.

 

Modern Medicine is cohesively curated;  the microscopic genetic imprint of life plays an influential role in determining body shape and size, and our susceptibility to diseases such as malaria. In embedding biomedicine within an rapidly evolving historical and cultural landscape, and undertaking to explore the future direction of biomedical science, the challenge Modern Medicine faces is to maintain its contemporaneity since opening in 2007.

Figure 1

 

 

Figure 2 

 

References:

1. Stearns PN. Fat history : bodies and beauty in the modern West.

New York: New York University Press: 1997.

2. van Dijck J. The transparent body : a cultural analysis of medical imaging. Seattle: University of Washington Press: 2005.

3. Hanna JN, Ritchie SA, Eisen DP et al. An outbreak of Plasmodium vivax malaria in Far North Queensland. Med J Aust 2002;180:24-28.

4. Spielman A, D’Antonio M. Mosquito : a natural history of our most persistent and deadly foe. London: Faber: 2001.

Written by Dr Joseph Ting; Adjunct Associate Professor, Faculty of Health and Social Work, Queensland University of Technology, Brisbane, and Senior Staff Specialist, Department of Emergency Medicine, Mater Health Services, Raymond Terrace, South Brisbane 4101. Email: jysting@uq.edu.au/ Joesph.Ting@mater.org.au