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Primum Non Nocere: An Artist’s Perspective into the World of Medicine

31 Aug, 17 | by amcfarlane

This guest blog post comes from Emma Barnard, a London based visual artist specialising in lens-based media and interdisciplinary practice and research within Fine Art and Medicine. Her solo retrospective exhibition Primum Non Nocere, focuses on the patient experience. The show has its private viewing on the 15th September 18.00-21.00, and then runs from the 16th September to the 7th October at Berlin’s Blue Art Gallery.

‘Without your medical file you don’t exist within this environment’. I will never forget those words, spoken to me by an ENT Consultant at what was the beginning of several years research as an artist into patient experience. This led me to the writings of French philosopher Michel Foucault and his book The Birth of the Clinic. It is said that Foucault coined the term ‘medical gaze’ to denote the dehumanizing medical separation of the patient’s body from the patient’s person or identity. Already at one of the most vulnerable times in their life, the patient can sometimes be viewed by their consultant as their diagnosis rather than as a person.

Mis(recognition) CType Photographic Print, 2013

We’ve all heard the stories. As a further education lecturer, I remember after a particular class in which I happened to mention that my work as an artist involved coming into contact with patients, some of whom had been given a cancer diagnosis, a learner approached me and told me that he was diagnosed with cancer several years ago. The diagnosis, he said, was delivered so badly that he was left without hope. On his return home he gathered his family together and prepared them for the worst. When he attended subsequent treatment he was advised that they were hopeful of a recovery. He looked haunted when he told me his story, tormented for years by the delivery of that diagnosis. Another time, a healthcare professional told me that after her diagnosis she walked outside, fell back against the wall, and collapsed sobbing as a result of what she’d just heard. At that point, I was horrified to hear, she told me that she thought that she would rather die than go through with the advised treatment.

I felt led to do my small part as an artist in offering patients a voice. After observing the consultation I invite the patient into another consulting room and discuss how it feels to be them: right here, right now. I’ve now spoken to hundreds of patients from various departments. Every single person has answered that question differently, often surprising the consultant when they are shown the patients’ drawing afterwards. During the consultation process patients’ show little emotion; it’s quite difficult to read how they really feel about the impact of the words spoken during the clinical encounter.

So many different patient stories flood my mind as I write this. The reality of cancer was brought home to me fairly early on as I witnessed a patient who was without their larynx and therefore communicated through writing to ask the doctor how long he had to live, he needed to get ‘his house in order’. It was difficult for me to remain unmoved as I sat and watched this scenario play out in front of his wife and grandchild. I still have that writing as a powerful testament. In our current climate, with the richness of many different languages being spoken and the issues that this situation may pose when there is no one to translate, how much more difficult must it be when a person is unable to use the ‘voice’ that they are born with?

Patients facing life-threatening illnesses are heroic; they have allowed me to witness the brutality of a treatment that is intended to cure them, from surgery, through to radiotherapy, chemotherapy and subsequent complications that may arise from being the recipient of these. I am constantly humbled by their generosity in allowing me an insight into their world, but also their sheer courage when faced with a diagnosis that rocks their very existence.

Out of hundreds of images I choose to show Martin’s. I know he will not mind me mentioning his name as, like many others, he is supportive of the work and keen for its exposure to a bigger audience. His writing cuts to the heart of what many cancer patients face when presented with their diagnosis.

This work has now grown to encompass the surgeon’s view, the patient pathway, the surgeon/patient dynamic, and to include the experience of being a doctor in a busy outpatient clinic. The following images contain snapshots of the doctors’ experience in clinic between patients.

As an artist working collaboratively with doctors I feel privileged to have been given a fascinating insight into the field of medicine and I have a huge amount of respect for them, the work that they do and the immense pressure that they are under. They have incredible workloads, are overbooked in clinic, coping with funding cuts whilst often dealing with potential projections from patients of being ‘miracle workers’ and ‘life-savers’. I’ve seen the exhaustion, the despair, heard about the strikes, and know that currently many doctors are leaving the NHS to go abroad – consequently, there are not enough doctors to cover the workload. In their 2002 presidential address, neurosurgeons Stan and Raina Pelofsky write: 

Martin Heidegger and Jean-Paul Sartre suggested that alienation occurs when we divide the world into two distinct parts: the ‘true’ world of science is on one side, and the ‘flawed’ world of human perception is on the other. It’s as if we try to strip ourselves of human values in order to understand this perfect scientific world, and we begin to substitute science for meaning. But science alone is empty, and it threatens to separate us from our human connections…we neurosurgeons may become separated from our patients through our use of new technologies, by the hassles of our professional lives, or by lack of time. This in turn makes us isolated.

We might think to ourselves: We are the doctors – they are the patients. They are sick – we are healthy. We are objective and scientific; they are objective and emotional. This is a form of alienation and we have to understand it if we are to find ways to soothe it and become connected to our patients and to the essence of medicine.


‘Profecta est Tableau Latin – Duo’, 2014, Giclee print on Hahnemühle Pearl

This solo exhibition will allow me an incredible opportunity to showcase the perspectives that I have witnessed over several years as an artist working within medicine. I am selecting from hundreds of never-before-published images taken over the years. Primum Non Nocere will provide an insight into patient experience and the surgeon and patient dynamic, and it will expound on the air of mystery surrounding the surgeon’s practice, the immense pressure that they are under, and the harm that this may cause them.

Primum Non Nocere

Private view: 15th Sept 18.00 – 21.00

Exhibition dates: 16th Sept  –  7th Oct

Exhibition Review: Transplant and Life

11 Apr, 17 | by amcfarlane

‘Transplant and Life’ Exhibition, Royal College of Surgeons, 22 November 2016 – 20 May 2017

John Wynne and Tim Wainwright

Review by Emma Barnard
Having on a couple of occasions visited the captivating, slightly morbid Hunterian Museum, housed in the majestic Royal College of Surgeons, Lincolns Inn Fields, my initial thoughts when being asked to write a review were, ‘How on earth could contemporary artists compete with such a visual feast?’

Well, compete they did and artists John Wynne and Tim Wainwright certainly didn’t disappoint. The exhibition is the result of their time spent with patients at the Royal Free and Harefield hospitals. As a fellow artist working within medicine, I understand all too well the complexities of gaining an insight into this fascinating world and the people, both doctors and patients, who work and are treated within it.

The exhibition “Transplant and Life” highlights and explores the intimate patient experience that is pertinent to transplant patients. It is contained within three sections:

The magnificent Crystal Gallery shows sixteen light boxes containing portraits of said patients, who have been captured beautifully by Tim Wainwright; they caught my gaze in a challenging, questioning way and long held it as I looked up at them. These patients are strong, courageous people and this is evident within their portraits. Not only stunning visually, the work also fills the museum with sound and voice in an integral and accomplished way. John Wynne has utilised ‘transducers’, devices that transform the glass cabinets themselves into sound producing surfaces so that the installation is sensitive to, and blends well with the space. The portraits can be viewed from many different angles and different floors and is successful on all levels, offering unusual viewpoints.

The double curved staircase which links the two main galleries features a video filmed during one of the patient participants’ thrice weekly dialysis sessions, illustrating what the person endures on a regular basis.

The Qvist Gallery has been turned into a black box; displayed in front of me is a video projection of still photographs, gently layered images, one fading into another, creating a surreal landscape of human beings discussing the patient experience from several different perspectives. Sounds emanate from the images on either side of me, one a handbag and the other a pair of bloodied theatre shoes.

People from all walks of life and social standing, and sometimes their relations, discuss their experiences of receiving a new organ, highlighting the fact that a human being embodies so much more than their diagnosis. Each person has their own unique narrative, they exist as three dimensional and not just as the recipient of someone else’s organ. The people interviewed are in various stages of organ transplant – some have recently had the transplant, others are recollecting something that happened ten years ago, although it still influences the way they live. It appears that organ transplantation leaves a legacy of sorts, an experience that remains with you on life’s journey. Naturally it’s an emotive subject and I wonder if that is the side that these patients have presented to their doctors or that this insight has been revealed only to the artists who orchestrated it and created the space needed for them to talk from the heart about their experiences.

They speak fondly of their donors, one individual naming her second child after the person who donated the organ that kept her alive.  Amongst the staring faces we see briefly the beauty of the surgeon’s hands working on a part of someone’s anatomy to the sound of church organ music, adding drama to the scene – a graphic reminder of what these patients have endured.

It is interesting to view how some people appear removed from the experience and talk about it from a very matter-of-fact medical viewpoint. This echoes my experience as an artist working with patients within an ENT department: sometimes the patient takes on the doctor’s language whilst they belong in the medical world.

After watching one still image gradually fade into another, I was taken by surprise by the last image: a portrait that I initially thought was a still image until I noticed one of his shoulders rising and falling as he breathed.

The following poem helps to summarise the experience that these people endured; it was written by one of the patients in the film, James Tottle, who along with other organ recipients has formed a band called the Gifted Organs:


It’s all done and dusted

In your hands entrusted

You’re the key to my restoration

From such loss you’ve helped me

Led me to my sanctuary

You’re the key to my restoration

This exhibition is a poignant reminder that the objects contained within the glass jars of the Hunterian Museum are of human origin.

I was curious to ask the artists the following questions:

What inspired you to embark on this work?

JW: This project follows directly on from the first Transplant project Tim and I did nearly 10 years ago, when we were artists in residence at Harefield Hospital for a year. I’ve always been interested in medicine, having grown up in a ‘medical family’: my father was a doctor, my mother was a nurse, and my sister became a doctor. I was intrigued to explore the soundscape of the hospital environment, and I have a long-standing interest in the voice and with socially-engaged arts practice, so the idea of recording first-hand patient stories also appealed to me. I enjoy the challenge of creating circumstances in which people feel comfortable enough to share what is most important to them.

I also enjoy the challenge of bringing my practice-based research into subject areas that are new to me: I start out, to paraphrase John Cage, not knowing what I’m doing – I know how to do that.

For Transplant and Life, we revisited some of the heart and lung transplant recipients we worked with 10 years ago as well as working with abdominal transplant patients at the Royal Free for the first time. Getting such a long-term view of the transplant patient experience is rare, if not unique, and it was one of many motivating factors for Transplant and Life.

TW: When I was doing the original ‘Transplant’ exhibition, I began thinking about the nature of the transformation experienced by the people I was meeting. They chose to pass through a process that took them close to death, but brought them back again into a new reality.

Alongside the medical and physical elements, there was an experience of suffering and of renewal that seemed to have a spiritual dimension that was seldom recognised or discussed.

Suffering, transformation and renewal is a narrative that we meet elsewhere. In some religious traditions, for example, there is a central story of how an experience of suffering leads to resurrection. In psychological treatment, people often pass through a process that they describe as the death of the old self and the making of a new one.

So in part, this project for me is a way of examining how organ transplantation can lead to the possibility of new life, rather than prolonging or resuscitating an old life.  Listening to their stories, it seems to me that people pass through suffering and emerge transformed.

Who was the work made for?

JW: We hoped that the project would make the life, death and identity issues raised by organ transplantation accessible to a broad audience. More specifically, the idea was to bring the patient voice and experience into the medical museum. The Hunterian has a massive footfall – they predicted nearly 50,000 visitors during our exhibition, so of course we hoped that at least some of those who came to see the collection would engage with the experiences, thoughts and emotions conveyed by our participants.

But we also made the work for the patients themselves, their families, and for others who may be going through similar experiences. When one patient at Harefield heard some of the recordings we put online, they commented that “I wish someone had told me some of this before I had my transplant.” That comment has always stuck with me, and I hope our work is of benefit to patients and their families, who don’t often have the opportunity to learn about the experiences of others.

We’ve also always been keen for medical professionals to engage with our work. The book from our previous Transplant project has been used for training / educational purposes at Harefield and in Johannesburg. See also below…

TW: Everyone.

Who has been your audience for this exhibition?

JW: The president of the RCS, Clare Marx, said at the opening of Transplant and Life that as a clinician she learned something from our work, and one of the surgeons with whom we worked, Bimbi Fernando, wrote to me that “In terms of what I have learned, it is perhaps the depth of the impact that having a transplant has on a patient and their family. In the day to day ward work, we don’t really get a chance to sit down and think about the impact … we pay lip service to it, but do we really think about it deeply? This work certainly allows us to do this!”

So, I hope other clinicians and medical professionals take time to engage with our work and that it has a positive effect on the way they work with patients.

I’m also interested in engaging audiences who may not have experienced much artwork that deals with medical subjects, people who come to it because they’re interested in sound art or installation or photography but perhaps hadn’t thought about what a sound artist might do in a hospital.

TW: From school kids to surgeons.

How will you use this experience and move on to your next body of work?

JW: I’m just starting on a project on noise, sound and sleep in hospitals for which we have received some seed funding from the King’s Cultural Institute. I’m working with a Professor of Nursing from King’s, an engineer from Imperial, a colleague from the University of the Arts London, and a couple of technology companies. The project aims to contribute to the holistic understanding of sound in the hospital environment and the intimate relationship of noise to sleep, rest, treatment and recovery. We hope to raise awareness of the issues around noise amongst nursing, medical and other hospital staff and also to explore creative and practical solutions that will contribute to patient wellbeing and potentially improve recovery times.

TW: I’m already making a new body of work and I’m really enjoying showing it away from the museum and gallery context. So, I guess the experience I use from this is to think very carefully about why and where I want to show my work.

For those interested in gaining an insight into the thoughts and feelings of being in the patient’s chair, their story and that of their friends and family, I would encourage you to go, see this and be inspired. But hurry; the exhibition ends on May 20th! It’s also your last chance to view the Hunterian Museum before it closes for three years for refurbishment.

Art review: chronic conditions and the digital age

9 Nov, 16 | by cquigley

Changing Lanes: Art in long term conditions in the digital age – new ways to adapt

By Shanali Perera

Rheumatic and musculoskeletal diseases are the largest growing burden of long term disability in the UK, affecting over 10 million adults. The concept of empowering patients to better engage with self-management of their long-term conditions is changing the world at an ever-increasing pace. Incorporating creativity can enhance interpersonal well-being.


Through my artwork, I aim to reflect my personal experience to raise awareness on ‘Creative empowerment – exploring the healing power of art’. Personal insights as a medic and a patient into integrating creativity, healing & health on the use of creative expression as a tool to face some of the physical limitations & challenges imposed by chronic illnesses. I am keen to tell others of my experiences as they may benefit from incorporating art or similar creative expressions into their own healing. Why not challenge illness dominance? I do so by using digital art.

I am currently a patient under the care of Rheumatology services at the Manchester Royal Infirmary, treated for vasculitis. I used digital applications for artwork to cope with pain, illness experience, adjust to living with vasculitis; to communicate with health providers, family and friends. Prior to ill health retirement, I was a Rheumatology specialist trainee and this journey has indeed been a transformative experience both personally and professionally.


Copyright © 2016 Shanali Perera

Eight years of numerous A&E and hospital admissions, multiple consultations from various disciplines have given me some valuable insights into a patient’s journey. Chronic diseases can turn one’s life upside down, gradually changing the landscape of daily living. Art can be a refuge for coping with the dynamic shifts in daily routine – accepting role limitations, altering perceptions and regaining some level of control. Creativity gives something to take control of and construct a positive identity. I like to highlight the potential benefits I felt by facilitating self-expression through creativity. Art was a tool for positive reinforcement and reflective thinking for me. I found expression through Art not only represents symbolic aspects of coping but also demonstrates the many facets of emotions and degrees of pain I feel at various points, as a visual narrative. This form of non-verbal communication is effective in helping family, friends and health team gain new insights into often under estimated, emotional/spiritual elements factored into the illness experience. Seeing beyond the illness – creative expression helping to redefine self-identity. I managed to achieve a semblance of normality by starting to set more realistic goals and standards for me around my limitations. From my experience, adapting to find ways around limitations plays a key role in rebuilding confidence and progressing forward. I feel that accepting the shift in roles, reshaping and reinventing one’s self is an essential part to living with a long-term illness.


People with certain disorders not only have to deal with the general disability of the chronic illness, but also the physical limitation of expressing the “art” that is in their mind. On repeated use my hands become numb and painful, pain radiating to my shoulders. I found the use of digital medium my adaptation as it enabled me to use light touch with minimal effort and alternate hands. Less pain and fatigue became apparent in my hands and arms compared to using a paintbrush on canvas or charcoal on paper. For me, artistic expression was a means of self-exploration to convey how I was feeling. This really helped me to keep the fun side alive and regain a degree of control. This newfound freedom to explore myself through the world of colours and inner creative space, gave rise to my present work.


Copyright © 2016 Shanali Perera


Copyright © 2016 Shanali Perera

I think art certainly can be used to explore and represent one’s individual journey -The way chronic illnesses are constantly changing shape, defining and re-defining itself. I feel that this aspect to self-care isn’t advocated to its full potential in people with long-term physical illnesses. There is a lot of scope to develop this further as a holistic approach to care given the wealth of studies illustrating the beneficial effects of integrating creativity and healing in long-term conditions. Present day represents the Digital age where Digital technology in healthcare is continually changing the world at anever-increasing pace. The use of digital medium/applications for creativity, especially for people with limited functional capacity/pain can be a constructive as well as an enjoyable pursuit to explore one’s creative side to cope with day-to-day struggles. Why not put this into wider use in the context of self-management of chronic illness? Let’s take a closer look at our creative space.

Be Visible! Be Heard! See yourself through art.

Correspondence to:

Art Review: Visions of Multiple Sclerosis

28 Oct, 16 | by cquigley


Hannah Laycocks’s Visions of Multiple Sclerosis: Perceiving Identity

Reviewed by Shahd Alshammari, PhD.


When artists’ work is considered provocative, you usually think that their choice of subject is taboo. While certainly not “taboo”, the disabled body, and even more interestingly the “invisible disabled body”, in itself a paradox, is a subject that medical practitioners and society continue to struggle with. What happens to the sense of ‘self’ when the body attacks the self, essentially its own being? Hannah Laycock’s photography exhibitions ‘Perceiving Identity’ and ‘Awakenings’ launched in 2015, both  exploring the disabled body and identity.

Laycock’s work is contemporary in its subject and form, while at the same time being rooted in her own personal experience with Multiple Sclerosis (MS). Like Hannah, I have similarly struggled with MS. Many times during the day, I tell my body to behave. I say it out loud. I talk to my body, telling her to wake up. With MS, the Central Nervous System – to some extent the mind – attacks the body. Disconnected, alienated from the body, there is a breakdown of communication. The body must wake up. That is my understanding of the title of the exhibition ‘Awakenings.’ I root it in a very subjective experience, while simultaneously recognizing the work’s significance in urging society to wake up, to open its eyes to “other” ways of living and being.

‘Perceiving Identity’, titled in the same thematic way that ‘Awakenings’ is, raises a central question of interest to Disability Scholars, namely identity. I have called MS, a ‘Random Disease’ in the past, one that changes one’s life course, though not necessarily affecting mortality. In one of the photographs (Figure 1), Laycock captures a simple shot of a road. Uncomplicated, it is a road that is not paved with stones, holes or obstacles. It is what it is. In fact, the colors on the road seem to resemble the light of rainbow colors. My own vision understands the colors as orange, green, and yellow. The choice of colors symbolizes the wide array of MS identities, and MS symptoms (no two individuals have the same symptoms; the course of the disease differs from one person to another). Color blends onto the road, and sometimes, since vision can be affected in MS patients, this is not always a pleasant experience. It becomes difficult to differentiate between spaces. Other questions that chronically ill patients have voiced or left unvoiced, suppressed, include “where will my life go from here?” The road is the map, the new map that you are handed along with the diagnosis. This is the path, as unknown and random as it is.


Figure 1. Copyright Hannah Laycock


Figure 2 is raw in its positioning of the artist at the forefront, as we are visually forced to focus on her back, on which she dangles what seems to be redcurrants, tracing her spine.


Figure 2. Copyright Hannah Laycock

The spine of course is affected in MS, as well as the brain. The redcurrant lands in its vibrancy along Laycock’s flesh, a strong contrast between the redness of the fruit and the artist’s skin. Redcurrants are supposedly beneficial in terms of a healthy immune system, efficient nerve transmission signalling, protection from free radical damage, amongst other potential effects.” Whether this is actually proven to help MS is not the point. It is yet another attempt at rebuilding a central nervous system that has chosen to break up with its significant other – the self, one’s identity. The artist holds the redcurrant in place, exhibiting control of her body, an attempt at the very least to alter the course of the disease, to do one’s part, to eat healthy, to be vigilant in fighting the disease.

All of the photographs that Laycock has beautifully presented share this theme of disconnection, of a breakdown of what is essentially communication between the mind and the body. As a Disability Studies scholar and someone who sees through the difficulty, and randomness, of living with this undefinable and uncanny disease (uncanny because it is unhomely, it is a body that used to house me just fine), I can say that Laycock’s work is bold and does not attempt to rectify or beautify or inspire. It recognizes the unpredictability and confusion of the disease, both for the patient and for medical practitioners. Nobody has answers, as frustrating as it is. Laycock’s work tells a fragmented narrative, part of the fragmentation of MS, of living with this disease, and seems to force you into her lived experience, rather than just standing along the sidelines, using diagnostic words, and labeling MS as ‘degenerative.’ The photographs carry a sense of closeness and intimacy. As viewers we are almost forced to stop and think about the literal and figurative meanings in Laycock’s artistic vision. Each photograph encourages us to pause and to ask “what is going on?”

And that question in itself is a repeated and dominant one in the lives of MS patients and neurologists attempting to diagnose and cure MS.

Hannah Laycock’s work can be viewed here:


Related reading

Devan Stahl, Darian Goldin Stahl. Seeing illness in art and medicine: a patient and printmaker collaboration. Med Humanities 2016;42:3 155159.

Exhibition Review: Rest & Its Discontents

6 Oct, 16 | by cquigley



Rest & Its Discontents Exhibition

Curated by Robert Devcic, founder of GV Art London

Mile End Art Pavilion, 30 September until 30 October 2016


Reviewed by Natasha Feiner


Modern life is busy, exhausting, and stressful. Yet, rest remains as important as ever. But what does it mean to rest in the modern world? Does rest, or its absence, impact on individual health and wellbeing?


London, UK. 4th March, 2016. Campaigners from the Mental Health Resistance Network and DPAC block traffic on the busy Old St round in portest against the use of Maximus job coaches in GP surgeries to "create jobs by prescription." They say disabled people will be bullied into unsuitable work and lose benefits through sanctions. Peter Marshall/Alamy Live News

Mental Health Resistance Network, Reclaiming our lives and work struggles past, present and future

Rest & Its Discontents, a major new exhibition exploring the dynamics of rest, seeks to answer these questions. It draws on the research of Hubbub, an international collective of social scientists, artists, humanities researchers, scientists, broadcasters, public engagement professionals and mental health experts. Over the past two years the team, based at the Wellcome Collection in London, has explored the dynamics of rest, exhaustion, noise, tumult, and work, as they operate in mental health, neuroscience, the arts and the everyday. This exhibition is their final major event.

Rest & Its Discontents features the work of over twenty-five Hubbub contributors. Work from a number of different academic disciplines is presented in a multitude of formats including audio recordings, film, and interactive installations. A number of topics are explored in the exhibition, including therapeutic relaxation, breath and musical ‘rest’, and sleep studies.


Antonia Barnett-McIntosh, Breath, still from film, 2015. Image courtesy of Ed Prosser


Nina Garthwaite, Default Mode Radio Network. Image courtesy Ed Prosser

Highlights include ‘The Cubiculum’, which invites visitors to explore the history of mind-wandering through sound and spoken word, and ‘Cartographies of Rest’, a multi-screen installation that visualises interactions between noise and mood.

The exhibition is accompanied by an event series, including workshops, poetry performances, and panel discussions with psychologists and journalists. I have booked tickets for ‘The Meditative Response’ workshop, which will bring together historian Ayesha Nathoo and composer Eugene Skeef. The workshop promises to ‘create a collective experience akin to the relaxation response’. Other events this month will centre on anti-work politics, self-tracking, and mental health.

A BBC Radio 4 series, The Anatomy of Rest, also accompanies the exhibition. First broadcast in September, the three-part series it is now available in full on BBC iPlayer. Presented by Claudia Hammond, the series asks what rest means to historians, poets, and neuroscientists. The final episode announces the results of the ‘Rest Test’, which asked 18,000 people from 193 countries why and how they rest. The data from the test has been visualised as a fabric pattern covering a series of benches in the Mile End exhibition space.


Claudia Hammond, The Rest Test & Rest Zone, 2016, digitial print. Image courtesy of LUSTlab

An open access publication, The Restless Compendium, explores many of the exhibition’s themes further. Comprising twenty-two essays on rest and its opposites, it extends and develops many of the exhibition’s major themes. The Restless Compendium is available here as a free download:

Rest & Its Discontents is wide-ranging in its exploration of rest and its opposites. It is, like the Hubbub project more broadly, truly interdisciplinary. As a result it offers novel and interesting perspectives that, while at times abstract, will no doubt interest humanities scholars, scientists, and medical practitioners. The exhibition is best enjoyed alongside its accompanying event series, radio show, and publication. These are all speak to each other and add new layers of depth and meaning to the installations and displays at the Mile End site.


SJ Fowler & Maja Jantar, Soundings III, 2016. Image courtesy of Ed Prosser


For more information, and to book events, visit:


The Mile End Art Pavilion, Clinton Road, London E3 4QY.

Opening hours 12:00-18:00, Tuesday-Sunday. Closed on Monday.

Late opening Thursday 6 October, until 21:00.

Admission is free.


Natasha Feiner is a PhD student at the University of Exeter. Twitter @natashafeiner.

THIS IS A VOICE at Wellcome Collection reviewed

16 Jun, 16 | by cquigley

L0081645 'His Masters Voice'. Painting by Franci

‘His Masters Voice’. Painting by Francis Barraud, 1919. Credit:Courtesy of the EMI Group Archive Trust



Wellcome Collection, 14 April – 31 July 2016

Reviewed by Steven Kenny


Approaching the exhibition entrance of THIS IS A VOICE at the Wellcome Collection, it is easy to think the voice is treated as criminal, being contained, controlled and its behaviour segregated from the world outside. Initial thoughts would suggest that it is being acoustically surveyed; with the steady opening and closing of the exhibition door, sound rushes to the exit. Yet its attempts are ultimately futile, the room has been sound proofed, noise restricted from accessing the outside world. On entering the space, grey triangular padded shapes line the walls, detail reminiscent of a kitsch science fiction film from the 1980s. The exposed patterned structures, evocative of the décor of Ridley Scott’s periled spaceship in Alien, enclose you in a warm, familiar hug of nostalgia. Sensing that this space is one visually tread before, it is easy to forget the prestigious institutional context of the exhibition. THIS IS A VOICE, a show investigating the potential of the voice in all its forms, techniques, objects and cultural baggage, is particularly engaging for it knowingly understands such a topic cannot be wholly represented (due to various cultural and language complexities). Yet it does a heartfelt job in attempting to at least understand how the voice as a product, both commercially and non-commercially viable, can be exhibited. Curatorial flourishes can be found everywhere, from the nooks and crannies of seated listening stations to the maze-like paths that allow a gentle flow of avid listeners from one space to the next. From attending numerous shows at the Wellcome Collection I must comment that THIS IS A VOICE is one of the most stimulating and generally refreshing exhibitions to be held in its space.

It would seem that an inner versus outer exploration of the body and the voice is focused on throughout. One telling example of this is immediately apparent in the work Circular Song, 1974 by Joan La Barbara. A half dome like structure hangs from the ceiling, the speaker’s hollow interior pervading the space below with sound. The experience of entering this wall of sound is generally unnerving, a constant and increasingly uncomfortable echo of inhaling and exhaling performed by the artist, breathes all over you. It is nightmarish, a deathly noise that would seem totally apt in the exhaling howls of a victim being chased by a stalker in a nerve inducing slasher film. Sound in this manner is represented as an abject substance, an uncanny emotional pulling of the visitors’ own sentiments to the body and the amplified vocalisation of a body process that now seems one of disgust. Yet this is in direct contrast to Marcus Coates multi-screen film installation Dawn Chorus, 2007, which is silly, funny and surprisingly touching. This room is filled with the fluttering sounds of birdsong, a number of monitors positioned at varying heights depicting subjects in everyday locations comically singing along to each sound created. Experiencing this work initially seemed deceptive­­–I could not understand how both image and sound aligned so perfectly, as though the birdsong was actually being produced by a human lip whistle. Subjects pursed their lips and jotted their heads up and down in perfect alignment. The façade is lifted on reading the work’s description: ‘After recording the dawn chorus with multiple microphones, the individual birdsongs were slowed down to last approximately 16 times as long, which enabled the participants to imitate them, while being filmed’. Yet not knowing these details did not matter as my imagination roamed freely around the space. I observed each subject as one would watch a bird in the wild, mesmerised by its harmonic whistle and merry bouncing of its head.


THIS IS A VOICE at Wellcome Collection, 2016. Credit:Photography by Michael Bowles

Dotted around the exhibition are various textual works, the written word laid bare. Erik Bunger’s wall text I Hearby Command You to Give Voice to These Letters Silently or Out Loud, 2011 was surprising in that it forced an involuntary restriction of my own voice from permeating the gallery. I so badly wanted to shout out loud the words I was reading yet thought better than to add to the already noisy space. Yet on second thoughts maybe that would have made for some interesting spectator reactions. Bunger’s playful register, was paralleled by Mikhail Karikis’s digital prints (photographs by Thierry Bal) Sculpting Voice, 2010, where the artist was photographically recorded pulling various facial gestures. Three prints line the wall in sequence, each exhibiting Karikis’s comically retuned face, made even more comical by the muting of what would probably have been quite a painful or otherwise loud projection of sound.

L0081817 THIS IS A VOICE at Wellcome Collection, p

THIS IS A VOICE at Wellcome Collection. Credit:Photography by Michael Bowles


The exhibition saved its loudest and most intriguing work for last. Entering the final room of the show, you would think that you might have woken in a Lynchian nightmare. Best described as an interactive, participatory constructed, sound installation, a lone and somewhat foredooming sound booth, tempts the spectator.

L0081800 Matthew Herbert, Chorus, 2016

Matthew Herbert, Chorus, 2016. Credit:Photography by Michael Bowles

The aptly titled Chorus, 2016 is by the British electronic musician Matthew Herbert, whose work ‘asks visitors to sing a single note within a professional recording booth following a set of instructions. The visitor’s voices are then automatically added to a chorus of voices, including performers and staff from the Royal Opera House, forming an ever-expanding sound installation that plays in the exhibition space and at the Royal Opera House’s Stage Door in Covent Garden’. I entered the space to sing the requested solitary note. Escaping my throat, my voice joined the squeaks, squeals, and sometimes correctly pitched notes above. Noise reverberated violently throughout the room, puncturing the space like a diminished fifth encroaching a melodic passage. The voice in this exhibition is presented as an ever-changing entity, one that is able to attack, calm and arrest.


Articles from Medical Humanities on the human voice:

Kelly BD. Searching for the patient’s voice in the Irish asylums. Med Humanit 2016;42:87-91.

Demjén Z and Semino E. Henry’s voices: the representation of auditory verbal hallucinations in an autobiographical narrative. Med Humanities 2015;41:1 5762.

Puustinen R. Voices to be heard—the many positions of a physician in Anton Chekhov’s short story, A Case History. Med Humanities 2000;26:1 3742.


Art, Life and Illness

16 May, 16 | by cquigley


David Marron: Encounters


Columba Quigley

GV Art London, David Marron, Geras 3, 2013, charcoal and acrylic on board, 60 x 42cm

David Marron, Geras 3, 2013. Image courtesy of the artist and GV Art, London

I was fortunate to catch this exhibition, held over the May Bank Holiday weekend at Lumen Studios, The Crypt, St John on Bethnal Green.

David Marron is both an artist and a paramedic.

The exhibition consisted of 12 pieces, charcoal, acrylic and collage on paper, standing on and supported by crutches.

These are multi-layered and complex works. As you stand before each, more unfolds with every moment of prolonged gaze.

Marron’s probing work is steeped in the essence of humanness, in the complexity, vulnerability and fragility of life itself and of those who inhabit it.

The artist’s experience as a paramedic affords him a unique viewpoint – that liminal space that he witnesses between wellness and illness, between living and dying, where life is suspended and where outcome is often unknown.

Following the exhibition, I had the opportunity to chat to Marron about his work. Initially trained in fine art, his working life brought him to the world of hospitals and the unwell. This witnessing, of the transformations and experiences of illness, changed the nature of Marron’s art. Previously, he reflects, his work had been more self-obsessed. Becoming part of the world of illness transported him away from a more personal interior world and towards a consideration of that of others.

In his work as a paramedic, Marron might only spend very short periods of time with patients on their journey to hospital. The encounters that moved him emotionally resulted in a transmutation of the feelings such interactions generated into the drawings on display. Yet each piece does not represent a single encounter or a specific individual, but is rather a conflation of a number of similar emotional experiences.

The piece Run Away Robin, for example, is not a direct portrait but was informed by a number of encounters with patients suffering from dementia. The piece represents a piecing together of the emotional fragments that Marron took away from such interactions: the nobility and stoicism that accompany the manner in which the elderly deal with memory loss; the masks they create, often using obstinacy and non compliance to hide their fears; and the fragmentation of self that accompanies the condition, here seen by the snippets of repeated words that hold meaning to the utterer even if uninterpretable by us.


GV Art London, David Marron, Run away Robin, 2015, charcoal and acrylic on paper, 84 x 59cm

David Marron, Run away Robin, 2015. Image courtesy of the artist and GV Art, London

A Tooth for a Tooth reminded me of Munch’s The Scream – that primordial sense of pain and anguish, seemingly uncommunicable in its silence. Any yet not, as we confront the distress so vividly here on canvas. The violence of this lived experience is hard to bear witness to, and yet there is so much tenderness in the lines that Marron draws to communicate this emotion that we rest our gaze and stay with the sufferer.

GV Art London, David Marron, A Tooth for a Tooth, 2014-15, Charcoal, acrylic and collage on paper, 84 x 59cm

David Marron, A Tooth for a Tooth, 2014-15. Image courtesy of the artist and GV Art, London

Marron is unafraid to share the challenges and pathos of the lived experience, witnessing it acutely as a paramedic. Yet his work also celebrates life throughout, most notably in Fentanyl Dreams, which vividly communicates the force of the newly born.

GV Art London, David Marron, Fentanyl Dreams, 2012-14, Charcoal, acrylic and collage on paper, 84 x 59cm

David Marron, Fentanyl Dreams, 2012-14. Image courtesy of the artist and GV Art, London

Marron is also a sculptor. However, for the works and themes presented in Encounters, drawing for the artist facilitated a unique truth and directness. He works quickly. Once inspired, the initial charcoal drawing is ready within 3-4 hours. Structures are built around this draft, followed by revisions. The sense of speed involved in their creation imbues the pieces with much energy and a less calculated finished product.

The exhibition also includes a video, En Route, which takes you on a journey through London, a horizontal view from within an ambulance. Buildings and sky whizz by, the world outside continuing and ignorant of what is happening inside the vehicle and within the world of the ill. The poem Ambulances by Philip Larkin came to mind:

‘Closed like confessionals, they thread

Loud noons of cities, giving back

None of the glances they absorb.

Light glossy grey, arms on a plaque,

They come to rest at any kerb:

All streets in time are visited.’


The poem ends:

‘Unreachable inside a room

The traffic parts to let go by

Brings closer what is left to come,

And dulls to distance all we are.’

from Ambulances, by Philip Larkin.


Our fragility, vulnerability, finiteness – further exemplified by the works being mounted on crutches – are clearly evidenced in Marron’s work, and are so beautifully communicated with much tenderness and compassion.

GV Art London, curators, producers & artist agent, represents David Marron amongst others.


A little Danish mermaid and other stories (of rare diseases)

7 May, 16 | by cquigley



A reflection on Sofie Layton’s Under the Microscope by Giovanni Biglino (Bristol Heart Institute, Bristol, UK)


The voice of a little girl and the sunlight filtering through layers of green batik – a series of coral-like structures representing real heart models displayed under bell jars – anatomical drawings – and the story of a boy’s heart transplant…

With her ambitious piece Under the Microscope, artist Sofie Layton has created two powerful installations, both rich in imagery and charged with people’s voices, during a yearlong residency at Great Ormond Street Hospital for Children in London.

The artwork aims to explore how patients and families process medical information, particularly in the context of rare diseases. Layton’s delicate rendition manages to achieve the aim and to go beyond, in a moving exploration that encapsulates the technicalities of scientific research around rare diseases as well as the strength of young people that are born with these conditions.

The installations focus on two different medical scenarios. In isolation is centered on severe combined immunodeficiency (SCID), whilst Making the invisible visible explores congenital heart disease.

The first recreates an isolation tent, made out of fluttering green/yellow batiks on which the artist has printed golden and silver viruses. Inside the tent, there is a bed, and a touching soundscape in which three voices alternate: a young Danish girl that candidly speaks about her growing up with SCID and the treatment she has received in the hospital; an immunology specialist discussing the condition; and the artist herself reading excerpts of H. C. Andersen’s Little Mermaid. The tent’s fabric suddenly transforms into a sea. The artist reads a bedtime story to the girl and tells us about transformation after treatment.


Figure 1: Visitors sitting on the bed inside the isolation tent.

The second is a powerful presentation of different facets of congenital heart disease – its shape, its frailty, its treatment, its narrative. The piece mixes 3D printed models, set on a steel table, with large silk panels on which the journey of a patient is symbolized in its phases, from anatomy to medication to new technologies that can help diagnosis and therapy.

The installations show stylistic links with previous work by Sofie Layton, particularly her piece Bedside manners (Evelina Children Hospital, 2014), which also included a site-specific installation with a bed and a soundscape, her intent clearly that of making the installation as immersive an experience as possible for the viewer. In the current piece, for instance, entering the isolation tent involves wearing latex gloves, a mask and a plastic apron, all of which immediately heighten the awareness of the viewer around the medical issue.

The artist has undoubtedly explored, appropriated and re-elaborated medical language in her process. Viruses’ names are scribbled in a doctor’s hurried handwriting on the fabric of the isolation tent, and language is central to the cardiac-themed piece, with five large silk panels listing congenital lesions, medications, technologies, but also keywords emerging from patients’ stories, all printed in the background of large anatomical drawings that, in turn, dialogue with the 3D anatomical models. Rather than a repetition of technical jargon, this creates an emphasis on the meaning and the power of these words – life-threatening conditions and life-saving medications, there shining on the precious silk backgrounds – technical/anatomical terms mixing with heartfelt imagery from patients’ narratives. Whilst the non-expert viewer would question the meaning of some of these words, the expert viewer would pause and wonder what stories are hidden behind and in between them. The language element is echoed in the soundscape, which opens with a young boy struggling to pronounce “ventricular assist device” (the boy, in real life, has been on mechanical heart support awaiting heart transplant).


Figure 2: Language is recurrent throughout the piece, such a name of viruses (left) and of cardiac conditions (bottom right), but also poignant quotations from parents and patients the artist has met during her residency (top right).

Another key element to the artistic research is an interesting exploration (microscopic and macroscopic) of shapes. On the one hand, viruses and cell structures are magnified. On the other hand, the anatomy of the heart and its variations in the presence of congenital lesions are beautifully presented with the use of 2D and 3D representations. The artist looks at the topography of the heart in a separate panel (exhibited in the entrance to Great Ormond Street Hospital), a rather abstract shape of intricate lines, a map, a blueprint of the engine room, but also suggesting other paths and other stories that have crossed. And 2D representations of the anatomy are complemented by the use of 3D models, manufactured from patients’ imaging data. Here the artist allows herself the license of going beyond the engineering aspect of 3D modeling, and includes in the cardiac landscape a small heart cast in bronze, which is suspended inside its bell jar – an evocative and immediate reminder of the preciousness of the organ.


Figure 3: A series of anatomical patient-specific models is presented under bell jars, including elements such as the suspended bronze heart (scaled from a medical model).

Layton’s work is exquisite in its layering. There is something rich and soft in the choice of silks. Something organic and fragile about the white 3D models. And a gentle lightness about the batiks of the isolation tent. But Layton’s work is above all exemplary in that is shows how art can be a powerful vehicle for sensitive stories charged with medical significance. The work is not sentimental or condescending and, albeit visually stunning, it does not embellish the pain of the stories it embodies. And equally it is not provocative, it does not intend to make the viewer uncomfortable by facing the complexity of rare diseases and the consequences on people’s lives. The work manages to strike a balance and what emerges, in the end, is a great respect for the humanity of the stories. The stories of patients, of course, but also the stories of their families, of physicians and their medical endeavors, and of researchers and scientists who look under the microscope in their daily practice.


Figure 4: Elements of the visual landscape of congenital heart disease. Left: one of five panels representing the journey of a patient, in this case medications, including a representation of a patient’s heart following multiple repairs of congenital lesions. Centre: a piece bringing together the voices of several patients and carers, every metal plate having been embossed by a different person with whom the artist developed a conversation during her residency. Right: representation of the topography of the heart.

The recognized importance of the narrative of illness experiences[1] is clearly central to the artist’s work, but so is the idea of the dialogue. The dialogue that she has had, through her participatory practice, with patients and families during workshops and on the wards of the hospital, over a period of several months. The dialogue that she has also fostered with researchers and clinicians, looking for that language she set out to explore in the first place, entering the lab herself and beginning to look under the microscope. This dialogue is completed with the inclusion of the viewer in the conversation, by means of the immersive nature of the pieces. The installations (both are site-specific for spaces in Great Ormond Street Hospital and the adjacent Institute of Child Health) rely on an array of media, including fabrics, embossed metals, the sculptural 3D models, but also soundscapes. The latter are absolutely integral to the installations and serve to further engage the viewer. Dr Jo Wray, health psychologist and senior research fellow at Great Ormond Street, remarked on the quality of the soundscapes, and how the looping of the recording is able to render the time element of living with rare diseases as something that represents itself day after day after day (for the patient but also for the carer). The viewer is thus included in the conversation and is also invited to look under the microscope. To look at the complexity of this world, crystalized in the technical jargon and juxtaposition of anatomical models – but also at the humanity that emerges so powerfully through the voices and through poetic quotations that the artist has blended in the pieces. “Now don’t suppose that there are only bare white sands at the bottom of the sea. No indeed! The most marvelous trees and flowers grow down there…” (H. C. Andersen)


Figure 5: Details of the isolation tent.


Note from the author: congenital heart disease is not, strictly speaking, a rare disease; however, some of the lesions depicted in Layton’s work represent cases of complex congenital heart disease and can be considered rare/unique in their anatomical arrangement.

Sofie Layton:

Go Create! Great Ormond Street Hospital arts programme:

Images courtesy of Stephen King. Do not reproduce without permission.


[1] Garden R. Who speaks for whom? Health humanities and the ethics of representation. Med Humanit 2015; 41:77-80

Tiger Country (Hampstead Theatre): A Review by Aneka Popat

13 Jan, 15 | by Deborah Bowman



For some, the workplace is synonymous with shiny desks, immaculate windows and a calm open sea of computers, complete with the reassuring hubbub of Monday morning gossip. Yet, for those that work in the capital’s hospitals, the workplace is a jungle where the gleam of a scalpel and the unforgiving glare of ward lighting mark the territory. We are in Tiger Country, a world where instinct stirs and we flirt with fate.


Nina Raine’s Tiger Country is a thrilling drama about professionalism, prejudice, romance, ambition and failure in an overburdened health service. It is far from the hyperbolic depictions of television soaps. It is frank and honest, exploring not only the daily challenges of a busy London hospital, but also the impact on the individual of being there both literally and metaphorically.


The emotional core of the play is with two ambitious female doctors, at different stages of their training, but each determined to succeed. Emily (Ruth Everett), a junior doctor, represents Tiger Country’s young blood. Though rigorous and thorough in all she does, we see her vulnerabilities as she attempts to juggle her professional identity and her relationship with medic boyfriend James (Luke Thompson). In contrast, Vashti (Indira Verma), the single and driven urology registrar rediscovers the identity that was increasingly obscured behind the surgical mask.


Raine seamlessly integrates medic ‘slang’, and inside jokes in her docu-play and avoids caricatures. The 14-strong cast creates a working hospital in all its diversity and detail. The squeaky wheels of hospital beds, the disposable coffee cup beside the computer station and the power walks of staff contribute to a stylistically sensitive set. The audience sits either side of the stage and is immersed in the frantic hospital environment. Fergus O’Hare deserves a special commendation for his sound design with Bollywood numbers sitting alongside the melodies of Nitin Sawhney.


Tiger Country is a sharp and quick-witted play about hospital culture. It offers more than a view of hospitals and the NHS. The piece is an intelligent examination of the human cost and achievements of medicine.


Tiger Country is at Hampstead Theatre until 17th January:


Aneka Popat, 4th Year Medical Student

St George’s, University of London



Cassandra (Royal Opera House): A Review by Rory Conn and Chloe Bulwer

2 Dec, 14 | by BMJ

Twenty years ago the ‘National Attitudes to Mental Illness Report’ was established. This annual survey, funded by the Department of Health, was devised to monitor changes in public opinion, recognised at the time to be primarily driven by misunderstanding and stigma.

On World Mental Health Day 2014, the latest in a series of encouraging figures from the survey were revealed. They showed that since 2011 an estimated 2 million people – 4.8% of the population – have demonstrated improved attitudes to mental illness. Much of this change is attributable to investment in anti-stigma campaigns, most notably “Time to Change”, a joint initiative of the charities Mind and Rethink. Additionally, or perhaps as a consequence, media portrayals of mental illness have shifted.

Not only are negative or alarmist news reports less frequently produced, there has been a cultural transformation in the depiction of mental illness in the cinema and on television. Producers are aware of a greater level of accountability in their work; their images of mental illness are better researched and tend to invite empathy and reflection rather than the scaremongering and ridicule of the past.

Now, it appears that this fruitful change has reached the theatre, as evidenced by the Royal Ballet’s performance of Cassandra, in Covent Garden. The show’s three co-creators, a choreographer, a singer-songwriter and a filmmaker all describe “deeply personal connections” to the themes of the production and it is surely this motivation which has inspired such a powerful piece, designed to challenge public assumptions of what it means to be ‘mad’.

A haunting and ethereal theatrical experience depicts with beautiful sensitivity the onset of a de novo psychotic illness in a young woman. A happy life, successful career and close family relations disintegrate before our eyes. Few words are needed; perceptual disturbances are described through disorientating and intrusive visual projections, then second and third person auditory hallucinations emerge, delivered via a discordant voiceover.

The medium of dance lends itself perfectly to the onset of psychomotor symptoms as the protagonist’s graceful movements become increasingly unpredictable and chaotic. Her mental state fluctuations are analogous to the erratic stockmarket variations of her high pressured trading job.

This is a thoughtful production, without hyperbole or gimmick. The degree of impact on family members, not often a feature of cultural depictions of mental illness, is profoundly delivered. Cassandra’s mother and brother oscillate between experiencing happy memories of her earlier times and acute distress at her clinical deterioration. Projections of an idyllic childhood interchange with fleeting abstract visions, including images of synaptic junctions and Rorschach plates. Such complexity of emotion is rarely achieved through dance. The depiction of carer burden is all the more poignant when one learns of the music producers’ brother, diagnosed with schizophrenia in his teenage years: the programme notes document her cathartic need “to keep his voice alive” by translating her own experiences to stage.

There is a critique of the process of medicalization, but this does not stray into the realms of anti-psychiatry. Cassandra is admitted to a stark hospital environment, where she remains under a spotlight, observed and exposed, at one point more than metaphorically. This sat uncomfortably for the professional viewer, but with good reason, speaking powerfully towards all patients’ potentially isolative and bewildering experience of an admission.


Gary Avis and Mara Galeazzi ©ROH, 2014. Photographed by Andrej Uspenski

(Gary Avis and Mara Galeazzi ©ROH, 2014)

Psychiatric professionals come and go metronomically, somewhat anonymously, the noise of a ticking clock accompanying their routine, but are ultimately seen to provide compassion and comfort in Cassandra’s greatest time of need. Importantly, the production’s balanced conclusion contains evidence of an improvement in Cassandra’s mental state but also a realistic sense that her life will never quite return to normality.

To their great credit, the producers have enlisted the advice of Dr Mark Salter, a consultant adult psychiatrist. His influence proves vital to the authenticity of the psychosis. After the production we met with Mark, who rightly appeared proud of the work. His main disappointment was that the psychiatrists had been dressed in white coats, an element he had wanted removed.

In Greek mythology Cassandra, daughter of the King of Troy, is blessed with the power of prophecy but cursed never to be believed. She predicts the fall of Troy but is dismissed as being insane. In some versions of the story, this very process drives her to madness. One of the many modern day descriptions of the ‘Cassandra Syndrome’ characterise an individual able to see or understand things long before others are able to reach the same conclusion. It can only be hoped that visionary productions such as this will provoke further attitudinal change so that one day we will wonder how we ever got it so wrong.


Dr Rory Conn is an ST5 in Child and Adolescent Psychiatry at The Tavistock and Portman NHS Foundation Trust

Dr Chloe Bulwer is an Academic Paediatric Trainee at the Institute of Child Health

Correspondence to:

Twitter: @roryconn

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