Updated: Sep 9, 2021
Recently I got asked, why surgery? This is a colossal question to answer, but an excellent question to discuss… Especially as I am still working out the answer myself as my knowledge of the discipline grows! So, I have decided to tackle this across a few blog posts. In this section I’m going to think back to my first time in theatre. Reading back on my fieldwork journal, and subsequent writings in my dissertation and final show, I’m hoping to explain a little of what captivated me during that first surgery.
In October 2015 (5 years ago – I’m in shock as I’ve just worked that out), I was fortunate enough to undergo fieldwork at the John Radcliffe Hospital in Oxford. I was there to undergo research for my art-school dissertation; The Surgeon Artist: an exploration of art and craft within surgical practice. I was to be shadowing surgeons to better understand their discipline; going to clinics, doctors room procedures, and to my delight, and apprehension, surgery. Little did I know this would be a crucial turning point within my artistic practice.
Everyone has no doubt heard the phrase “thrown in at the deep end”; well my first experience of surgery was just that. I watched a full cranial reconstruction, and in English that means I essentially watched a group of surgeons and other medical staff remove the skull from a 18 month old child, break it into pieces and put it back on. Believe it or not, this is a routine operation for children suffering from premature fusing of the sutures in skull… but not for a twenty-something art student who was quickly wondering what she’d got herself into.
Ken Currie - The Three Oncologists
I remember being shocked on first entering the operating room by the glare of bright lights on white surfaces. In retrospect my preconceived perceptions were ridiculous, blaming my expectation of a shadowy theatre with spotlights on Ken Currie’s painting of the oncologists (one of my favourite paintings of all time and hung in the National Portrait Gallery here in Edinburgh). In the painting, Currie’s surgeons are ghostlike, alone, appearing to be at deaths-door themselves which does not fill the onlooker with a lot of trust in their abilities. This could not be any further from the truth when entering the brightly lit theatre, packed with various people all going about their tasks… Knowing where to stand so that I was not in the way was lesson number one.
While the atmosphere in the room was intense, there was also a level of joviality, an excited hum, an anticipation... It reminded me of something a surgeon called Henry March (2007) said in the BBC documentary The English Surgeon; ‘I seem to perk up a bit before surgery. Not sure if it’s blood-lust or training’. Just as athletes limber and psych up before a race, the staff all went about their business, preparing, checking once, checking twice, “warming up” for the work at hand. Surgery is considered a ‘blood sport’ (March 2007) and as I watched the surgeons make the first incisions with the scalpel the anticipation was infectious, and I found myself leaning forward with an eagerness and fascination I had not expected.
Gunther Von Hagen - Body Worlds, London
As the layers of the body were revealed and manipulated I remember being awed by the changes in colour and texture of each individual layer. Witnessing these on a live patient puts into stark contrast the lack of colour and rigidity of cadavers that I had previously worked from. The contrast between organs and vessels that are alive compared to the preserved cadaver was staggering. For those who have never had the, and I cannot say “pleasure” here, but maybe the “experience” of seeing a cadaver, take for example Gunther von Hagen’s Body World’s exhibition and the plasticised models he displays. Despite them being utterly fascinating, they can in no way be thought of as real, they are missing the ever-shifting, ever-developing, life-force that animates the body.
As I watched on in awe at the simultaneous series of events undertaken by the anaesthetists, nurses and surgeons, a voice suddenly called ‘How’s the little one doing?’. It was the neurosurgeon announcing his arrival, and thus signalling the next stage of the surgery, where neuro and plastics worked together in removing the pieces of the skull safely away from the Dura membrane (the only thing that would later separate the brain from the outside world).
However, his arrival also brought on something different… nausea.
With the words ‘little one’ I was broken out of the spell the surgeons’ hands had put me under, back into an alien room where a one-year-old’s scalp was pulled right back exposing his skull.
Surgeons and medical practitioners acquire ways of dealing with objectification, something I quickly learnt and have developed over the years. You have to cross difficult boundaries of objectification that are now second nature. Post-surgery the surgeon commented on the ability to objectify saying ‘you have to distance yourself otherwise there’s too much emotion flying around and nothing would get done’. Surgery is unlike art in this sense, artists are encouraged to develop emotional ties to their subjects and work. The goal being an embodiment of emotion, a painting a conversation the artist has with the paint and board, a relationship developed between them. Yet, saying this, objectivity is not black and white, a good surgeon will be objective in the operating room, but empathetic beyond those walls. One of the anaesthetists said to me that ‘It’s good to keep reminding yourself every so often that that is a person, otherwise you become almost too detached. I don’t want to lose my humanity, it’s what keeps me on edge’.
Interestingly when talking to the anaesthetists, I noticed they did not need to watch the monitors the entire time, but listened for the beeps; able to differentiate each machine and understand exactly what was happening. To anyone else, the cacophony of beeps, buzzing, drilling and swishing of scrubs and robes fill the theatre, would just be the background noise, the orchestra’s accompaniment. But to the medical staff they mean so much more. They tell a secret story that only they are privy too. Someone with a musical background may be able to listen to the beeps and tell you where they come on a scale, but they would not be able to tell you if the patient’s heart-rate was dropping or their blood pressure rising. Each note, or beep, providing an answer to a question that the skilled ear was asking. I am unable to explain the story that the symphony of beeps was telling, but that does not mean I didn’t appreciate their significance. Much like watching an Italian Opera, just because I don’t understand a thing, doesn’t stop me appreciating the spectacle.
But what has shaped me and my work most, is that as the surgeons worked on the patient I found myself spellbound by their hands. At one point there were six hands all working together, fingers weaving and holding, pulling and clamping. Each minute movement is an important decisive action, there is no hesitation. Harold Rosenberg declared that ‘what abstract painters did was perform an action on a canvas, the way a bullfighter performs an action in the ring’ (Danto 2013), just like, in my opinion, the surgeons perform an action with their tools. In keeping with science and academia, we know that each movement has been developed to be the most efficient and beneficial to the patient, and yet I was mesmerised as I watched their hands seemingly dance around each other with practiced expertise, skill, and grace.
The surgeon became a performer, their hands the performance, and the operating room, the stage (I now fully appreciate why they used to call it a theatre!).
It was watching the surgeons’ hands, their embodied skill, this tacit skill, that made the biggest impression. Throughout art school I felt constantly confronted by lecturers and other art students in my decision to pursue realist painting. “Painting is dead”, “why bother painting like a photograph when you can just take a photograph?”, “this is a dead-end”. The importance rarely lay in the skill, but in the concept at art-school. While the status of skill in art, especially representational art, is continuously challenged in the contemporary art world, skill is the foundation of surgery.
Here, in this operating room, I was watching a manifestation of skill, and I was in awe… and I was jealous; because it was skill developed to a high degree, it was the acquisition of craftmanship, that allowed for the surgeon’s hands to become this incredible site of transformation.