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Stories From the Birthing Room

15 May, 17 | by amcfarlane

Sue Wiseman, Professor of Seventeenth Century Literature at Birkbeck University of London, is organising an event entitled “Stories From the Birthing Room” during Birkbeck’s annual Arts Week. Here she discusses the event and some of the issues that she hopes will be open for discussion.

‘I wil not use any kind of sorcery or incantation at the time of travail [labour] of any woman; and .. .I will not destroy the child born of any woman, nor cut, nor pull off the head therof or otherwise dismember or hurt the same’ (Evenden, 2000, appendix A). This was the oath sworn by Eleanor Paed in sixteenth century Canterbury and, notwithstanding the scenes of carnage conjured here, she was a woman’s friend in time of trouble – a midwife. What do texts like these begin to tell us about the early modern birthing room? “Stories From the Birthing Room” combines a seminar and scripted performance to analyse what we can learn when we combine law, myth, life-narrative and theatre as they disclose what was at stake in birth.

A woman’s lying-in was a complex time in early modern England. It was both a time of ritual and celebration and, potentially, a time at which soci0-economic ruptures and tensions could be made discomfortingly, even murderously, real. Perhaps paradoxically, given that it was expected to be a time of sequestration and secrecy (some midwives’ contracts specified secrecy from men), the lying-in process also generated a plethora of complex meanings. From the knives that might be used to cut the woman, or to cut free a dead foetus, to the midwife or to any appearance of a man, most presences in the birthing room were imbued with significance, uncertainty, and often conflict. Accordingly, what happens in the secrecy of the birthing room has left a large textual corpus.

For many years scholarship was, in many ways, dominated by the single issue of men versus women as controllers of birth. This debate focussed on the gradual masculine takeover of the birthing chamber in the eighteenth century. At first it was shaped by scholars’ “uncritical acceptance” of the self-interestedly negative image of midwives presented by the men who superseded their authority, and then characterised by scholarship vigorously and effectively challenging that account (2000, p. 1). The past two decades have seen a shift in interests with more research focussing on the seventeenth century and earlier, and a welcome diversification of topics and approaches. For example, Doreen Evenden has made a detailed study of the licensing of London midwives and tracked many of their lives and, setting the lying-in chamber in the context of court testimony, Laura Gowing has illuminated what was at stake in that room and how economic and legal forces, as well as powerful feelings, shaped women’s relationships to each other (Evenden, 2000; Gowing, 2003). Thus, it is clear that some of the information that discloses men’s rise to power over both birth and the way it was recorded in writing can tell us about other aspects of society too, and that we can also use fresh sources and begin to consider togther texts scholars usually divide up along disciplinary boundaries – such as strictly medical, legal texts, theatre texts, and case notes.

Stories From the Birthing Room’ starts with the all-female space of the chamber of birth to show afresh the many ways it radiated significance in early modern England. Putting beside each other texts from very distinct spheres of writing – legal, theatrical and medical – we hope to show the power of women’s secrets to generate revealing responses in many kinds of writing. At the same time, the seventeenth century is not well served by resources on the birthing room and we will make these some of these stories lastingly available to a wider audience by dramatizing and filming them.

The event’s hypothesis is that uniting the archives and approaches usually used by social historians, historians of medicine, literary scholars and practice-led theatre researchers would be likely to extend our sense of the ways the stories of lying in were told and potentially point to new approaches. So, we open with a seminar held by London Renaissance Seminar at which Dr Leah Astbury will discuss preparations for birth. Dr Adrian Wilson, following up his path-breaking work on women and obstetrics, turns his attention to birth and myth, exploring the myths surrounding the Caesarian section of Jane Seymour, mother of Henry VIII’s male heir – who died soon after his birth. Dr Isabel Davis asks about the medical and political implications of Mary Tudor’s expected, celebrated, but never delivered, infant. The second part of the event brings together texts from the courtroom, case history and theatre chosen by scholars in different disciplines. Thus, building on her research in Common Bodies Professor Laura Gowing has chosen texts from case papers and legal testimony. Dr Isabel Davies, drawing on her work on conception which involves both pre-modern texts and collaboration with artist, Anna Burel, speaks on legal and religio-politcal texts on Mary’s pregnancy. Susan Wiseman, exploring the elite and the non-elite in seventeenth-century England, selects texts from case notes that in telling birth narratives shape a life-story for women whose lives are rarely written – the vagrant, the disabled, the domestically abused. Crucially, Dr Emma Whipday, playwright, theatre director and academic, has brought together her roles by selecting theatre texts that tell, but also question, the scene of birth.

Considering together legal, theatrical and ‘medical’ texts generates both findings and questions. For example, if we see theatre, court and case history together it is immediately clear that voice was important, and often authoritative, in seventeenth-century oral-literate culture. Eleanor Paed’s oath was both oral and textual, acknowledging the diverse literacies present, but it was not part of a residual culture in being heard. Rather, it was part of a culture simultaneously spoken and written; though it can be approached diachronically as shifting in balance towards the prioritisation of the written, it is also the case that the definitive shift took place in the eighteenth century. As Adam Fox puts it, in sixteenth- and seventeenth-century England “the three media of speech, script and print infused and interacted with each other in a myriad ways” (Fox, 2000, 5). In the texts we explore, women’s voices appear in the trial testimony, yet of course they are changed by the process of recording; in seeing women’s agency in such testimony how should we balance the fact that they record public testimony actively made against masculine and institutional shaping? How should we understand female voices on the stage? In what ways, if any, should we hear the voicing of women’s experience by a female playwright as distinct from the male playwright’s texts about lying-in? If, in the astrological notebooks and case notes on troubled people of practitioner Richard Napier’s, women outnumber men and many of these were suffering problems that sprang from lying-in, how far can we consider ourselves having access to the thoughts of the poorer women of Buckinghamshire and Northamptonshire who told him their stories of “dangerous labours” (MacDonald, 1981 38)?

Thus, in an exchange we will hear during Emma Whipday’s performance, in Margaret Cavendish’s play The Convent of Pleasure (1668) a character asks if a midwife has come to attend her lady. She hasn’t because “she cannot come, for she hath been with a Lady that hath been in strong labour these three days of a dead child, and ’tis thought she cannot be delivered”. However, when the midwife suddenly does arrive it is because the earlier woman “could not be delivered, and so she died”. “Pray tell not our Lady so”, replies the first “for, the very fright of not being able to bring forth a Child will kill her”. (Cavendish, 1668, scene ix). Such material presents a scenario strikingly similar to that found in legal papers when birth goes wrong, in case notes and apparently in women’s testimony. It has the strong appearance of being a record of speech, yet, of course, it is a prescription for speech – a play (although, in fact, a play we think was not performed at the time of its composition and publication). So, as we see, seventeenth-century England was not operating with a sense of an original ‘voice’; if plays and case records don’t give us access to an unmediated subject that is something they share with other texts of the period, yet, at the same time, in many cases it is a female voice that has been heard or imagined, in a public situation.

While if we ask which text – play, oath, ballad or case note – gives greatest access to the lying-in room, we can give no definitive answer; they tell us different things – and often ones which exist in contradiction. Yet, putting together a range of sources is likely to tell us much more than looking at a single kind of text.

References

Cavendish, Margaret. Plays, London, 1668

Evenden, Doreen.  The Midwives of Seventeenth-Century London, Cambridge: Cambridge University Press, 2000.

Fox, Adam. Oral and Literate Culture in England 1500-1700, Oxford: Oxford University Press, 2000.

Gowing, Laura. Common Bodies: Women, Touch and Power in Seventeenth-Century England, New Haven and London: Yale University Press, 2003.

MacDonald, Michael. Mystical Bedlam: Madness, Anxiety, and Healing in Seventeenth-Century England, Cambridge: Cambridge University Press, 1981.

Book Review: Notes From the Sick Room

9 May, 17 | by amcfarlane

Notes from the Sick Room by Steve Finbow, London: Repeater Books, 2017, 343 pages, £8.99.

Reviewed by Alan Radley, Emeritus Professor of Social Psychology, Loughborough University

This is a book about sickness, more specifically about the illnesses of a number of well-known artists and philosophers. It is also about the illness history of the book’s author, Steve Finbow. He uses his own experiences of illness (and they are many and varied) to introduce the reader to the travails and writings of the individuals whose sickness he explores. The word ‘travails’ is apposite here as it suggests that illness can be, if not a life’s work, then a determining factor in how people live their lives, as well as rendering their experience meaningful through writing and other forms of art. Key to this is the idea that being trapped in a diseased body opens up the possibility of escape through self-examination, issuing in a productive outcome. To make this argument Finbow explores in detail the circumstances and reflections upon illness of several artists and writers. He introduces us to cancer in the life and death of people such as J G Ballard, Iain Banks, Christopher Hitchens and John Diamond. Finbow details the sufferings of Frida Kahlo after the bus crash that severely damaged her pelvis; the effects of being shot upon Andy Warhol and his art; the denials of illness that were part of Bruce Chatwin’s extensive travelling; and the descriptions of and insights into illness offered by writers such as Katharine Mansfield and Virginia Woolf.

How should one tackle a subject like sickness while providing detailed biographical detail about one’s own and others’ illness, at the same time weaving a complex argument drawing upon philosophers such as Nietzsche and Foucault? Finbow achieves this by treating the book as a virtual hospital – a clinical space – populated by celebrity patients and some celebrity doctors (e.g. Susan Sontag). The entries and exits from the various departments to which he escorts the reader are managed in part by introducing us (in detail) to his own medical history. These extend from a pain in the buttock to severe pancreatic necrosis and a spell in intensive care, all illuminated by details from his medical notes. In the case of the pain in the buttock, Finbow uses this as an approach to the question of whether cancer is alien to or part of the self and, in the case of the latter, how it might become so. Turning on the issue of denial, he argues that the denial of disease (“flight to sanity”) is not healthy, but that health tolerates disintegration and, by implication, transforms it through art and writing.

The idea that illness and the state of being sick can be the bases of productive art is expressed in a quote that Finbow provides, in which John Berger says of Frida Kahlo: “The capacity to feel pain is, her art laments, the first condition of being sentient. The sensitivity of her own mutilated body made her aware of the skin of everything alive – trees, fruit, water, birds, and, naturally, other women and men. And so, in painting her own image, as if on her skin, she speaks of the whole sentient world” (322). By drawing attention to this Finbow is agreeing with Nietzsche and Foucault that art is an act of freedom-making borne of suffering. This extends to the person’s life – including their art – so that what is rendered is expressive of a way of being rather than illness per se. It is perhaps for this reason that he objects to Susan Sontag’s attack on the use of metaphor as aestheticizing the “what should not be imagined”  – the abhorrent disease that is cancer. To this Finbow replies, “what nonsense”, and argues that when Sontag wrote about cancer in her book Illness as Metaphor (1978) she was, in effect, aestheticizing it.

The problem here is that there is a difference to be made between aesthetics and aestheticization. Aestheticizing, at its root, directs the viewer/reader to the artist/author rather than the object. An artwork is the product of a transformation that directs our attention to the ineffable; it is this that, in part, gives it aesthetic value. This is not always an easy line to draw, but it matters in this book because Finbow treats of both aesthetics and aestheticization in the course of his descriptions and discussions. By dramatising the artists and writers he discusses as either patients or doctors, Finbow risks muddling this distinction. So, for example, he writes: “Dr Sontag sits back in her chair, her fingers pyramided above the desk, the silver streak (poliosis) in her hair illuminated by the overhead fluorescent strip lights”. And later, “She closes the book, gets up, takes me by the crook of the arm and says authoritatively, ‘Let’s go to your office. I think we need to have a little chat’” (300). For this reader at least, these passages had the effect of displacing attention from the book’s argument about illness to the author’s interest in his subject matter, which at times I found unhelpful.

In terms of the book’s overall aim Finbow goes some way to demonstrating that illness improves the work of the artists considered, though he does not show exactly how art draws upon illness. Instead, the book remains a bricolage of ideas that coheres as a sort of image, a story of the necessity of ill health in our lives. Its overall message – drawn from Nietzsche – that life needs illness, is incomplete without it, is an important one. Health is not separate from illness, and a deeper understanding of health includes the idea that it can be strengthened by illness. And for that, and its historical and biographical detail, Notes from the Sick Room makes for a most useful and interesting read.

Alan Radley is the author of Works of Illness: Narrative, Picturing and the Social Response to Serious Disease. Ashby-de-la-Zouch: InkerMen Press, 2009.

Book Review: Deleuze and Baudrillard: From Cyberpunk to Biopunk

25 Apr, 17 | by amcfarlane

Deleuze and Baudrillard: From Cyberpunk to Biopunk by Sean McQueen, Edinburgh: Edinburgh University Press, 2016, 288 pages, £70.

Reviewed by Dr Anna McFarlane (University of Glasgow)

Sean McQueen’s first monograph ambitiously aims to create “a cognitive mapping of the transition from late capitalism to biocapitalism” (1) and to do this through tracing trends in science fiction from the cyberpunk movement of the 1980s and early 90s through to a subgenre only recently designated as ‘biopunk’. Following Fredric Jameson, a scholar known for his analysis of postmodernism and Marxism in late capitalism, McQueen argues that cyberpunk is the quintessential literature of late capitalism and therefore a fitting place to begin his analysis of this recent cultural movement from late capitalism to biocapitalism which, McQueen argues, “is the frontline of capitalism today, promising to enrich and prolong our lives, whilst threatening to extend capitalism’s capacity to command our hearts and minds” (1-2).  In McQueen’s schema this is a transition from the ‘control’ of late capitalism to the ‘contagion’ of a biocapitalism that he argues is an increasing threat to individuality and the autonomy of the body.

The book’s title belies its contents to some extent, given that the first half of the book does not focus on texts from cyberpunk’s ‘canon’, such as it is, but focuses on the ‘cyber-‘ aspect of cyberpunk to investigate texts that engage with the concept of control. Anthony Burgess’s A Clockwork Orange (1962) is not generally considered cyberpunk-proper in reviews of the genre, but its themes of control, and of the renegade individual fighting subjection by the state, certainly resonate with the work of figures in the cyberpunk canon such as William Gibson and Pat Cadigan. Another of McQueen’s chosen texts, JG Ballard’s novel Crash (1973), has been subject to debate about the extent to which it can be considered science fiction, let alone cyberpunk. Such deviations from the ostensible theme may be traces of the monograph’s origins as McQueen’s PhD thesis, but their reworking in this monograph is satisfying for those coming to the book for considerations of Deleuzian and Baudrillardian thought, who might consider the texts to which their philosophies are applied a secondary consideration. McQueen successfully cuts through the archaeology of decades of readings and misreadings of these two thinkers, often with a sharp word for scholars who come to the original philosophy with their own preconceptions, and hence leave it repeating unjustified or inconsistent critiques of these two thinkers. His own readings come across as fresh and new, perhaps because he works against a backdrop of scholars who have become too accustomed to invoking the names of Deleuze and Baudrillard without putting in the time to tackle their complex bodies of work first-hand.

The primary interest in the book for scholars of the medical humanities comes in the latter half, where McQueen turns to biopunk. This is a relatively new term in science fiction scholarship (following in the -punk traditions of cyberpunk, steampunk, and dieselpunk, to name but a few), but McQueen finds the term’s origins in classic science fiction, such as Mary Shelley’s Frankenstein (1818, commonly considered science fiction’s foundational text) and HG Wells’s The Island of Dr Moreau (1896). The first example of contemporary biopunk McQueen draws upon is Vincenzo Natali’s 2009 film Splice, in which a couple who work for a pharmaceutical company use DNA to create a hybrid creature.

The film draws on the tradition of Frankenstein to express fears of uncontrollable technological change, while also specifically critiquing a biocapitalism guided primarily by profit margins, rather than by philosophical or ethical considerations about the effects of its research.

McQueen’s readings of Deleuze and Baudrillard focus on some of these thinkers’ key concepts, how these have been relevant to cyberpunk and its investigation of ‘control’, and how they might function in contemporary debates about the ‘contagion’ that McQueen finds characteristic of biopunk. He contrasts Deleuze’s concept of the ‘body without organs’ with Slavoj Žižek’s ‘organs without a body’, both of which attempt to offer a representation of desire without the restrictions of hierarchy (to draw on only one valency discussed in the book). Žižek provides something of a bridge between Deleuze and Baudrillard here, as his Lacanian impulses are echoed in Baudrillard’s attempts to consider psychoanalysis, and how it might function in a society defined by the imaginary realm of consumption and consumer fetishism. Under biocapitalism, the consumption impulse could quickly move towards the point where the market’s freedom to use cells and discarded bodily tissue for profit is in tension with the long-held belief that it is immoral to profit from the cells of organs – as argued by Marlon Rachquel Moore in a recent article for BMJ Medical Humanities, “Opposed to the being of Henrietta: bioslavery, pop culture and the third life of HeLa cells”, which teases out the historical racial injustice that is now being relived, without hope of reparations, by the family of Henrietta Lacks whose ‘immortal’ cells continue to be the basis for untold profit in the biotechnology industry. The move from co-opting the labour of classes of the population under slavery, and later forms of capitalism, to co-opting the use-value of the body itself is the journey with which McQueen engages here as he moves from readings of Karl Čapek’s R.U.R. (Rossum’s Universal Robots) (1921), the science fiction play that brought the word ‘robot’ into English usage, and Eric Garcia’s The Repossession Mambo (2009, filmed in 2010 as Repo Men) which sees a biounderclass fitted out with artificial organs and forced to pay crippling interest rates or face having their organs repossessed – and dying in the process.

The electronic copy of this book, from which I reviewed, leaves something to be desired. Like many academic books, it uses endnotes which cannot be easily referenced as one reads in the electronic form, and the book’s use of abbreviations for the major works of Deleuze and Baudrillard exacerbate this problem as the reference list at the beginning of the book cannot be easily consulted. This makes for particular difficulties when quotes from the major texts are picked out as introductory to chapters and their sections, leaving the reader occasionally unsure as to which of the theorists is being quoted. However, the content of the book ultimately extends the case for considering biopunk as a unique and important subgenre of science fiction that, in turn, deals with the unique and important development of biocapitalism. McQueen’s readings of Baudrillard and Deleuze manage to scrape away some of the sedimented assumptions and misreadings of the past and offer exciting new ways to consider their work. His reference to both major and minor texts from both thinkers will introduce readers to insights they had not previously considered – again, especially relevant to students of the medical humanities might be Baudrillard’s comparison between cancer and capitalism in The Transparency of Evil (1990), the biopolitics of organ transplantation in Kazuo Ishiguro’s Never Let Me Go (2005), or Thierry Bardini’s account of subjectivity after bioengineering, Junkware, which McQueen turns to in his final chapter reading of Brandon Cronenberg’s Antiviral (2012).

As I pointed out above, McQueen’s book does not always stick to the limits laid out in his title, (for example when he reads texts that are not considered archetypically ‘cyberpunk’ under that rubric, or in the latter half of the monograph where Foucault’s thought is just as crucial to his argument as that of either Deleuze or Baudrillard), and his book should come with a warning for those who have never tackled Deleuze or Baudrillard before, given the slew of concepts that are not fully unpacked here for beginners. However, the book that emerges is cohesive and amounts to an often passionate argument for considering class consciousness in the era of bioengineering, biohacking, and biopolitics.

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:

Restoration

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.

Romanticizing Tubercolosis

21 Mar, 17 | by amcfarlane

Radu Jude (Director of ‘Scarred hearts’) and the Screening Room Editor of Medical Humanities, Khalid Ali, met at the London Film Festival, October 2016.

Our screening editor, Dr Khalid Ali (Khalid.ali@bsuh.nhs.uk), here writes about the importance of Romanian director Radu Jude’s new film Scarred Hearts (Romania, 2016) and interviews him at the London Film Festival in the podcast included below.

Each year on the 24th of March, several organizations around the world celebrate ‘International Tuberculosis Day’. It serves as a timely reminder that TB still remains an international epidemic claiming the lives of an estimated 1.4 million people, making TB one of the top 10 fatal diseases, and the emergence of 480,000 multidrug-resistant TB cases annually according to the Global Health Observatory data report- 2015. Before ‘Streptomycin’ was discovered as an effective anti-tuberculous drug in 1944, TB was a devastating disease with an inevitable death sentence. Radu Jude, award winning Romanian film director, revisits the TB epidemic in the early twentieth century in Scarred Hearts. The film is based on the life of Max Blecher (1909-1938), a Romanian writer who wrote the book Inimi Cicatrizate based on his own affliction with TB.

Scarred Hearts is a close examination of the life of Emanuel (Lucian Tedor), a Jewish Romanian young man in his twenties from a privileged background in the turbulent times of WWII, who falls ill with Pott’s disease (TB of the spine). Emanuel is admitted to a sanatorium, were he spends years bed-ridden, contemplating life, love, and illness. While meditating and writing his books and essays, Emanuel meets and befriends fellow patients and nurses. His encounters with the sanatorium’s resident doctor are short and traumatic; one such encounter happens when the doctor evacuates an abscess from his back with little analgesia, if any. The days go by slowly in his confined solitary world, while some nights are livened by ‘carnal activities’ with a young, female nurse, and another patient affected by TB. With the war exploding outside, boredom and melancholy set in in the dark corners of the sanatorium. The budding companionship and friendly exchanges with other inpatients over smoking, drinking alcohol, and playing cards, make the sanatorium a safe refuge for creativity in writing literature and composing essays, human interactions, friendships, and love. Some patients even decide to stay in the hospital indefinitely, and take up voluntary roles caring for other patients, showing altruism and human sacrifice. Self-management in chronic conditions is a relatively new concept in medical literature; however, Emanuel in 1930s Romania embodied the essence of self-management in ‘surviving a bed-bound existence with resilience and hope’. The socio-economic dimension of TB in today’s world plays an important factor in making it a universal public health and social challenge. Co-ordinated health and social interventions are as much needed today as they were in the mid 1930s.

Throughout history, TB has been given several names:  consumption disease, The White plague (a seventeenth-century TB epidemic in Europe and North America), Phthisis (a term which appeared in Greek literature around 460 BC, and was used by Hippocrates), Scrofula (TB of the lymph glands), and Pott’s disease. It was also referred to as the ‘Romantic disease’ as a lot of its sufferers were young adults at the time of the Romantic movement in European art, literature, and philosophy. Throughout history several notable literary figures suffered from TB; Jane Austen, Emily Bronte, John Keats, Anton Chekov, Franz Kafka, Khalil Gibran, and George Orwell are some examples. However, Max Blecher stands out in documenting his journey with TB in Inimi Cicatrizate.

It is interesting to note that Max Blecher was studying medicine in Paris when he had spinal TB. He was forced to abandon studying medicine, and become institutionalised in hospital settings until his untimely death at the age of 28. As a medical student and a writer, he had several qualities which are essential in both vocations; keen observation, building a rapport with those around him by actively listening to them, and transforming all those interactions and experience into a coherent form of story-telling. It goes without question that ‘empathy’ was a driving force in his analysis of the physical and emotional facets of illness. He was indeed bed-bound, but his eyes and ears were wide-open to the suffering and misery around him. Documenting his thoughts and philosophy in writing might have helped him stay sane, hanging on to some form of well-being in the bleakest of circumstances. Mother Theresa once said ‘The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted’. Reminding ourselves on Friday 24th March 2017 of the global impact of TB, its sufferers are no longer alone or unwanted.

Listen to the interview with Radu Jude, director of Scarred Hearts:

The European Doctors Orchestra and the Irish Medical Choir

24 Feb, 17 | by cquigley

 

Professor Des O’Neill

One of the pleasures of medicine is the frequent sense of a shared vision of how enmeshed it is with the humanities. As a group, doctors tend to have a high level of cultural engagement: for example, our own studies show that over 50% of medical students play, or have played an instrument http://mh.bmj.com/content/42/2/109.long.  Yet we rarely celebrate our cultural participation in a collegial manner, and perhaps it is time that we more openly acknowledged this shared portal to the bigger picture in life and medicine.

These elements came to life vividly at a remarkable workshop in Belfast in early February for the nascent Irish Medical Choir. It arose because the very talented European Doctors Orchestra https://www.europeandoctorsorchestra.com/ has decided to scale new heights with a concert in Belfast in November featuring Mahler’s mighty 2nd symphony, the Resurrection Symphony https://www.europeandoctorsorchestra.com/next-concerts/.

As the work has an extensive choral finale (as well as the chill-inducing Urlicht in the fourth movement http://onlinelibrary.wiley.com/doi/10.1196/annals.1360.041/abstract ), a bright idea was to recruit a chorus drawn from medical practitioners and students across the island of Ireland.

The take-up has been fantastic, with a waiting list of highly qualified sopranos and altos, albeit some space yet for tenors, a constant for choral societies around the world! The introductory workshop was an intense pleasure at many levels, with virtually all specialties represented, and ranging from medical students to those retired for many years, a very intergenerational project.

Having expected a direct exposure to the Mahler, we were initially surprised by the list of works provided by the expert and engaging choir master, Brian MacKay http://www.zezerearts.com/brian-mackay-artistic-director. In the event it was a brilliantly constructed voyage around Mahler, proving as ever that the elliptical beats the direct approach every time.

Our choral journey allowed us to engage with historical and contemporary contexts for Mahler’s music, preparing the soil for future rehearsals. The first work was an eighteenth century hymn by Graun based on a Klopstock poem on the resurrection. It is this piece, played at the funeral of the celebrated conductor Han von Bülow, which inspired Mahler to use the poem in the symphony and it was both simple and affecting.

A perspective of late-romantic German choral music was provided by Josef Rheinberger’s Abendlied, a truly beautiful piece which was a fantastic discovery for most of us (and do watch out for his (and Reger’s) brilliant re-working of the Goldberg Variations for piano four-hands http://www.tal-groethuysen.de/cds/bach-goldberg-variations.html!).

We then immersed ourselves in another avenue of spiritual music, the potent and deep Rejoice, O Virgin, from Rachmaninov’s Vespers. It was a visceral shock to be a part of this extraordinary music, a further intensification of the feelings arising from my recent exploration of choral singing http://blogs.bmj.com/bmj/2017/01/03/desmond-oneill-singing-in-the-new-year/.

Friendships and connections were forged over lunch, and I was in awe at the wide range of pursuits and achievements of those present, and sense of shared pleasure and purpose.  After some business arrangements for upcoming rehearsals, we then sight read twice through the first movement of Brahms German Requiem, further extending our aesthetic, communal, pleasurable and spiritual journey.

For a group dealing with illness and death throughout our working lives, there is something extraordinary reassuring and quietly energizing about this participation in music probing mortality, resurrection and a deep sense of consolation. All of these composers had more extensive personal exposure to death than we do http://blogs.bmj.com/bmj/2011/05/24/des-oneill-death-and-transfiguration/ and their music provides an extra layer of opportunities to see the bigger picture, echoing and providing a more positive spin to Milan Kundera’s dictum that all we can do in the face of that ineluctable defeat called life is to try to understand it.

The coda to the meeting was a clear desire to continue an Irish Medical Choir after the Mahler, a testament to the organizers, our choir master, and those positive elements in medical life which make it such an interesting and satisfying career. If you are a Mahler fan, do consider joining us in the Ulster Hall on Sunday, the 26th of November: all proceeds will go to music and health charities.

 

Des O’Neill is a professor of geriatric medicine and co-chair of the Medical and Health Humanities Initiative at Trinity College Dublin https://www.tcd.ie/trinitylongroomhub/medical-humanities/

Editor-in-Chief post at Medical Humanities

25 Jan, 17 | by cquigley

 

The Institute of Medical Ethics and BMJ are looking for the next Editor-in-Chief who can continue to shape Medical Humanities into a dynamic resource for a rapidly evolving field. Candidates should be active in the field, keen to facilitate international perspectives and maintain an awareness of trends and hot topics. The successful candidate will act as an ambassador for the journal supporting both pioneering authors and academics publishing their first papers. The candidate will also actively promote and strengthen the journal whilst upholding the highest ethical standards of professional practice. International and joint applications are welcomed.

Interviews will be held on 24th March 2017.

Term of office is 5 years; the role will take 12-15 hours a week.

Contact Kelly Horwood (khorwood@bmj.com) for more information and to apply with your CV and cover letter outlining your interest and your vision for future development of the journal.

Application deadline: 24th February 2017.

Start date: June 2017

Further information here.

Blog Curator and Books Editor Opportunity

18 Jan, 17 | by cquigley

Blog Curator and Books Editor Opportunity

 

We have a vacancy for a Blog Curator and Books Editor at Medical Humanities. It is a single, combined role as all book reviews are published on the Blog.

The role involves:

·         Commissioning and editing content, including reviews, for the Medical Humanities Blog;

·         Maintaining the Medical Humanities Blog and updating it regularly (currently on a weekly schedule, but this could be flexible within reason);

·         Liaising with publishers to receive new titles and organise reviews of relevant books for the Blog;

·         Contributing to the editorial team (comprising the editor-in-chief, associate editors and BMJ Publishing staff) that leads and manages both the journal and Blog, including attending the annual editorial team meeting;

·         Curating the content of the Blog to reflect the journal’s identity, priorities and interests;

·         Working with social media platforms to provide a coherent online presence for Medical Humanities

 

The role is flexible and can be adapted according to the successful applicant’s interests and availability. On average, the role takes approximately 4-6 hours per week. It is an exciting and creative opportunity to join a diverse and well-supported editorial team.

If you are interested in the role, you are welcome to contact the Editor-in-Chief, Prof. Deborah Bowman, for an informal and confidential discussion. Her email address is dbowman@sgul.ac.uk.

Applications, comprising a letter setting out a) the reasons for applying and b) suitability for the role and a curriculum vitae, should be submitted to Deborah Bowman at the above email address

Institute of Medical Ethics Conference 2017: Call for Papers

19 Dec, 16 | by cquigley

4th IME Summer Conference, June 2017

 

Building on the success of three previous conferences held in Edinburgh, Newcastle and London, the 4th Institute of Medical Ethics (IME) Summer Conference will take place on the 15th and 16th of June in Liverpool. Two changes have been made to the conference format for 2017. First, the Research Committee will accept proposals for both individual papers as well as for panels. The latter will be allocated 75mins and the time can be used for traditional presentations of 15-20 mins or for more collaborative and discursive interactions. Second, there is a specific call for contributions from the medical humanities. The IME’s Research Committee hopes to include a stream of medical humanities papers across both days of the conference.

Confirmed Keynote Speakers are Prof Rosamund Scott (KCL) and Prof. Stephen Wilkinson (Lancaster).

Further information can be found here: http://ime.datawareonline.co.uk/Event-Booking/EventId/1023 and both the IME (@IMEweb) and various members of the IME’s Research Committee can be found on twitter if you want to get in touch.

Finally, the location and date of this year’s conference have been coordinated with the annual conference of the UK Clinical Ethics Network (UKCEN). Themed ‘Family Matters’ this will be their 17th Annual Conference. It takes place on the 14th June 2017 and there will be a short IME/ UKCEN crossover session on the morning of the 15th. For further details about UKCEN’s conference see: http://www.ukcen.net/

 

Politics and Medicine

9 Dec, 16 | by cquigley

Clinicians should understand how they can use the ballot box to advance their patients’ health interests.

Jacob King, Deniz Kaya

Medical Students, Peninsula College of Medicine and Dentistry

 

As a health professional working in a sterile environment one might easily find themselves feeling disparately removed from the slimy world of politics. But sadly we believe that this separation of clinic and state denies the measurable effects they have upon each other. Environmental public health acts, improving access to medical coverage, and taxes on ‘bad behaviours’ have all been platforms for political campaigns, each subsequently having shown powerful health benefits.

We have a duty to patient wellbeing, and some argue that this extends to advising or lobbying government. But in light of recent major democratic exercises, including the EU referendum and junior doctors’ contract votes here in the UK, and the upcoming Trump presidency, the ballot box can frequently become a vessel for enacting changes for patient health. Unfortunately, we fear that health professionals are missing out on this key opportunity to address their patient’s wellbeing from an entirely new angle, one normally out of reach for the individual clinician. In the only study of its kind Grande et al. show that US physicians were significantly less likely to vote than the general public [1]. They suggest that medical training may lead physicians to perceive voting as in conflict with their professional duties. Anecdotally, among our colleagues, we also find disillusionment with the political system, limited understanding of legislative processes and little appreciation of health and social policy impact. The GMC’s ‘Tomorrow’s Doctors’ sets the framework of a medical school curriculum, and simply requires students to “discuss the principles underlying the development of health and health service policy” [2]. This limited criterion for health policy teaching, we believe, fails to adequately prepare health professionals. It follows that if greater awareness was fostered toward the impact and variety of health policy options, health professionals could more readily be able to advance patient health by means of their vote. Supplementary teaching of political systems and health policy could be incorporated into a medical curriculum which recognizes the importance of political decision in healthcare. Initially teaching politics effectively may seem implausible. Yet we have experience of teaching, and being taught medical ethics quite successfully without running into contentious arguments, cries of bias or questioning of practical use. We see no reason why politics should be any different.

There is a broader point here, however. Just as this blog routinely demonstrates, the role that accepting humanities topics (sociology, art, music, anthropology, religious and cultural studies et cetera) into medicine has progresses hidden and tangible clinical benefits – we claim that political science possesses similar potential. “A physician is obligated to consider more than a diseased organ, more even than the whole man, he must view the man in his world.” (-Dr Harvey Cushing). Small “p” politics by any definition must also fall into the category of humanities, concerned with forms of individual thought and behaviour, power structures, interpersonal relations, as a cousin of sociology, psychology and anthropology. But while earlier we suggested that at least some measure of political science education for health professionals might theoretically improve our voting rates, fuel broader discussion of health and social policy or directly lead to effective health outcomes via the ballot box, the hidden side of recognising political belief in oneself and our patients may also (akin to its humanities cousins) result in a greater appreciation of the man in his world.

In this light we wish to make the case that political awareness will on one hand prime clinicians to appreciate on a different level the background and health beliefs of their patients, and on the other, confer a greater idea how voting one way or another may play a role in improving health and wellbeing.

Whether one ultimately does vote in what they deem to be in their patient’s best interests is a personal matter. Individuals of course have other motivations on which to base their decisions. However we reasonably believe that health professionals should have the opportunity, foundation knowledge and confidence to enact change via the ballot if they wish to do so.

 

References

  1. Grande D, Asch DA, Armstrong K. Do doctors vote? J Gen Intern Med, 2007;22(5): 585–589.
  1. General Medical Council. Tomorrow’s Doctors: Outcomes and standards for undergraduate medical education. 2009.

 

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