Speaker: Dr Richard Barnett, historian of medicine and Wellcome Trust Engagement Fellow
Facilitator: Frances Stonor Saunders, historian and journalist
A few days ago, my husband and I went to a talk at the Wellcome Collection “Disenchanted Flesh”, and with a title like that, who could resist? Frances Stoner Saunders was joined in conversation by historian Dr Richard Barnett to discuss his new book ‘The Sick Rose’ about the golden age of medical illustration.
We’re both fans of the gruesome side of science and this event did not disappoint. In fact, after seeing one particular image, I had to consider whether I should have resisted (more on that later).
The first thing I should say is that both speakers were astoundingly engaging, usually my mind unwittingly drifts during long discussions, but Ms Saunders and Dr Barnett, both endearing and fiercely intelligent, had me eating out of their hands, gobbling up each word with intense interest.
The discussion covered many aspects and one that I found interesting was the subject of appropriation. As Dr Barnett himself has noted “What are the implications when a book like The Sick Rose appropriates pictures of suffering people and dissected bodies? How, in other words, should we look at these images? More bluntly, should we look at them?” It’s an interesting question and one for which I have no answer. One thing I do know however, is that there is something fascinating about these images, and perhaps not only these images but all that we consider gruesome. I can say that, at least to me, there was something very beautiful about the illustrations.
Yes, I said beautiful and I’m sticking to it, and moreover, it’s not just me. From Da Vinci’s grotesques to Francis Bacon’s deformed (I’m not sure that’s the right word) portraits, many artists have over the course of centuries been intrigued by what most would consider ugly.
Examples of Da Vinci’s Grotesque Heads
Indeed Francis Bacon, in speaking in an interview about his seminal work, Three Studies for Figures at the Base of a Crucifixion c.1944, stated the great influence of medical illustration in his work:
‘I found an old book in Paris on diseases of the mouth. It must have been a nineteenth century book; I don’t really know quite what date it was. And they were hand-coloured plates of these different diseases of the mouth, and they always interested me and the colours were beautiful. As you know, people read things into everything; they always say that mouths have a strong sexual influence. Well, they probably do. And I have no religious feelings but at the same time I was [going to] do a crucifixion and put these figures around the base of it. And the only reason I ever used the crucifixion [was] because it was an armature on which I could hang certain sensations.’
Three Studies for Figures at the Base of a Crucifixion c.1944
Another point that the discussion brought up was the question of the individuals involved, the patients. Many times, especially nowadays, medical illustration displays the disease as separate to the individual. Disconnecting it from its host and the human implications. Ironically these new illustrations, though clearer for educational purposes, are far from an accurate representation of what a surgeon sees on the operating table. A liver is rarely how it looks in the textbooks, it is connected to many tissues, organs, veins, muscles and other biological elements. Indeed modern medical illustration tends to take things out of context. This however was not the case during the periods portrayed in this book. Images of diseases and illnesses are shown in these illustrations to be inseparable with the patient. Boils, infections and tumours are not regarded on their own but attached to arms, breasts, ears, genitals and other areas that they have infected. It is this humanising of conditions that make some images quite difficult to view and for a variety of reasons.
In some illustrations, the patient is seen looking back at the viewer, their suffering and fear evident.
Other images while not showing the face can still be troubling to look at as the ambiguity of a faceless body part can fire up the imagination by showing what could happen to any human body, including yours. Almost like those great Hitchcock films that never showed gore because the director knew that whatever gruesome image he could display is nothing compared to what the audience’s imaginations could conjure up.
One particular image that I found hard to look at for long, as I mentioned earlier, was of Syphilis on the vagina. I wonder how long it took for the artist to be able to engage in sex after having to concentrate on that graphic image. I for one was traumatised for the next few days despite only briefly gazing at it before quickly averting my eyes for fear the outlines would etch themselves in my brain. Fortunately for me, I couldn’t find an image of it to use here so my mind is safe for another day.
Of course the portrayal of many of the patients raises another very important issue, one of consent. It is very likely that the doctors and artists did not gain the consent of the patients before creating their works.
This is Rose, she contracted a fatal illness and was dead within hours. If I remember correctly, the amount of time between the two pictures was roughly four hours. This is one of the most haunting images of the book and for many reasons. The before and after portraits are shocking especially considereing the very short amount of time between them, the artist must have been affected by the fast deterioration of this once beautiful woman. Which begs the question, who was she? Was she a sister, a mother, a lover? Was she kind as her first pose suggests? In fact the facial expressions here are striking for their contrasts. To see an image of a suffering patient is one thing but to be able to compare it to the happier image before really makes one think and empathise.
Beyond the empathetic, however, lies a matter of ethics. In her last hours, was she made to sit before an artist, and was it against her will or did she (unlikely) give her consent to be represented. The general consensus is that at the time, doctors would simply have brought in an artist and informed the patient that they were to be painted. Unless you were an influential member of society, it wasn’t a choice.
Indeed, despite the fact that all the works are very well executed and, through their use, man has been able to educate himself regarding the anatomy of disease and the recognition of their symptoms, it’s still important to note that many of these works record moments that Dr Barnett calls “remarkable indignity” and thereby the ethical side of the practice is brought into question.
Here we can see two such examples:
This one I find particularly interesting as the artist has taken the time to wrap the patient in a beatiful white material, creating a strong contrast between the harsh ugly diseased body and the soft beatiful fabric. He almost makes the image look classical in style.
Dr Barnett is not unaware of these issues and in response to the use of the images in his book he states quite insightfully, “These images are, to borrow a phrase from Claude Lévi-Strauss, good to think with. Working with them has made me reconsider the impulses that led clinicians and librarians to keep them out of public circulation, and the factors that now lead us to digitise and upload them for a global audience. They should shock us, move us, jolt us out of any sense of complacency over our individual or collective wellbeing; something would be wrong if they did not. They are a magnificent historical and aesthetic resource, and a record of human suffering and of attempts to understand and to relieve it. We would be all the poorer if they were concealed; equally, they should not become mere visual shorthand for a kitsch, knowing and emptily ironised attitude to sickness, suffering and death.
At the same time, though, I am drawn to wonder whether, in a culture built on the primacy of the visual, and in which aspects of our identity are dispersed in a digital sandstorm of images and text, these images are also in some sense human remains. And that makes me want to be very, very careful about what I do with them.”
The event was highly enjoyable and there were so many other issues covered, too many for my brain to remember but I hope I gave an Idea of what it encapsulated. If you’re interested in finding out more, you can buy the beautifully designed book here