Sunday, October 29, 2006
Friday, October 27, 2006
Although not without interest, I found this Radio 3 play on insomnia oddly soporific! Janice Kerbel's Nick Silver Can't Sleep is part of Artangel's Nights of London series of artist-led projects exploring the city with people who wake, work or watch over it. Kerbel developed her project in conversation with insomniacs, sleep scientists and botanists. Listen again here after 4th November.
Wednesday, October 25, 2006
Franz Kafka's modern classic Metamorphosis is showing at the Lyric theatre in Hammersmith until Sat 28th October.
The bizarre tale of a man who wakes up to find himself turned into a giant spider and his family's response to this comes alive beautifully on stage. Set to an original, haunting soundtrack, the 2 storey stage allows the audience to simultaneously experience the changing reactions of the family from fear and disbelief to transient kindness followed by negligence and downright ruthlessness , alongside the increasing isolation and suffering of the transformed man.
I was struck by the parallel situation of various people with chronic diseases such as cancers but also mental illness, which is heavily stigmatised because it is so poorly understood from both the clinical and public perspectives. I found the sense of betrayal by the sister was particularly poignant, in contrast to the denial and indifference exhibited by his parents.
With the exception of a few humourous interludes (I think designed to take the edge off the raw emotions felt by the audience), the play stays faithful to the story. Incredibly powerful - well worth seeing.
Friday, October 20, 2006
Colm Toibin’s writing style is deft and engaging. One cannot help but hear the Irish accent in his dialogue. ‘Oh look who it is now, look at her, look at her hair!’ shouts Granny at a panelist on the The Late Late Show. There are plenty of humorous interludes to lighten what would otherwise be a rather solemn narrative.
The decommissioned Blackwater Lightship of the title is a metaphor for the unfathomable loss of something expected to be consistently dependable – like the love of a mother or daughter.
The doctor, although she doesn't feature prominently in the story, comes off refreshingly well in this account. She is a consultant known to her patients as ‘Louise’. She’s given out her home number and is caring, worried and engaged in spite of the inevitability of Declan’s condition. Declan's friend Paul was medically literate in a way that seemed a credible and respectful reflection of the knowledge carers acquire through proximity and experience with chronic illness.
I didn’t know that this novel included an illness narrative when I plucked it off the shelf. I can recommend it as a lyrical account of family relationships in times of crisis.
Friday, October 13, 2006
The film, which I should warn you is long, is divided into three parts. Part 1 deals with the workings of the unconscious in movies. It maps the way film uses Freudian concepts to confront anxiety, and of this Hitchcock is exemplary. Part 2 looks at desire: this part is particularly persuasive about how fantasy is used to escape reality but when fantasies become real they are even more nightmarish than reality. He draws on Solaris, The Piano Teacher and David Lynch's movies to demonstrate. Part 3 is about illusion. We know film is an illusion but why do we still find it so convincing? Zizek shows how even when we know what will happen, we still are drawn in by the subjective experience of spectatorship.
What makes this film so much more than a lecture, is that Zizek travels to locations and interperlates himself into the sets of the movies he discusses. Zizek's style is witty and frank, and his emotional intesity on screen makes him as good a performer as any RADA-schooled actor. Probably predictably, he draws mainly from the horror genre which lend themselves most readily to Freudian/Lacanian concepts of subjecthood, but the array of films referred to is wide: The Matrix, Eyes Wide Shut, Blue Velvet, The Tramp, to name but a few
Fascinating, enlightening and enjoyable -- everyone interested in film and representation should see this movie. I recommend seeing it in the cinema as the clips have much more presence than on TV. But if you can't make it to the ICA before 2 November and you're interested in the ideas, an edited transcription is here.
Thursday, October 12, 2006
In the same issue is an article by James Thomas from Leeds on the value of creative writing and poetry to medical education. Hear, hear!
Tuesday, October 10, 2006
Not so much a coathanger round an old sock as a rat down a drainpipe! Sorry, I know it's not exactly relevant to medical humanities but Tz's last post and The Guardian's piece on this new work in the Tate Modern's Turbine Hall just seemed to coincide - serendipity or what? It's Test Site, Carsten Holler's latest at Tate Modern. Apparently you reach speeds of 30mph as you descend. God only knows what that does to you. I feel a PCC outing coming on!
I am inspired to write because for the last two hours in between breastfeeding my teething baby back to sleep, I’ve been filling in the details of my colonoscopies of the last few months on an Excel spreadsheet. Mind-numbing, hence the break. However, it has set me thinking. I had a break from even this for a year to have my baby. At present I am entering the data from before I left to have her. My success rate is quantifiable - and I have just, after 3 months, made it back to pre-baby levels.
The colon is a long loopy thing. Passing this bendy tube round it is just difficult enough to be a challenge (luckily for the patient, or not, depending on your view). It is akin to trying to pass a coat hanger through a very long sock with your eyes shut. And, like surgery, you don’t mind doing the same thing again and again if it is complex enough, as there is a satisfaction to doing this well, and a motivation to keep improving and making it more efficient, or more elegant. I remember timing my appendectomies until I had done one in 25 minutes from first incision to finishing sewing up. After that, I felt cutting the time down further would be a triumph of bravado over safety so I stopped timing. The next challenge came with perfecting the size of the incision, and then with training others. I have spoken to some old greybeards who say that it all palls in the end. And all you are left with is the money. But that would be cynical.
The process of learning is predictable. There are known, anatomical bends in this thing and they are like markers of your learning curve. First, get out of the rectum my dear. This is particularly hard in women who’ve had a hysterectomy (so they say... this may just be the kind of surgical folklore which is brought in to buttress up one’s ego after failing at something). Indeed, one of my first bosses used to give me 3 minutes (the time he could, bravado all the way, make it all the way round in) at the beginning of each colon. I spent 3 months up the recta of half the population of that small seaside town before I ever made it out of a rectum... And so it goes on. Splenic flexure, hepatic, and that final hurdle, the ileocaecal valve. Despite being at separate ends of the scope, with very different opinions as to whether it should be advancing or withdrawing, you and the patient jointly cheer when it gets to the end – the delightful sight of the only recognizable bit of bowel drawing into view like a long-awaited harbour: the caecum. I even don’t mind a bit of the brown stuff here (very un poo-like and liquid. The scope ensures there is very little smell, and when you turn the hepatic corner into the last lap, often with difficulty and a sense of triumph, the poo has also, you note, been struggling to make it round the corner. Its lakes are a welcome sight of homecoming.)
Perhaps I haven’t mentioned colonoscopy because its outer reaches (inner reaches) are not for the faint-hearted. Indeed, they might make you think I was weird.. Well, I am glad to say that for once I was joined the whole trip round by a patient who was just as weird the other day. He’d had some of the usual jollop which I often suspect is over-dosed in order to render the patient a proper, asleep well-behaved patient who doesn't interrupt. Only, occasionally it has the paradoxical effect of inducing intense garrulousness. One of the recognised jobs of the endoscopy nurse is to take over talking to the talkative patient so that you can get on with the test. Serious. This patient, however was different. He was interesting. At least, many may be interesting only one doesn’t have time for small talk when one is wrestling with the splenic flexure. But he was interested in what he was seeing. So are many patients of the well-informed, not hung-up variety. But this bloke was just free-forming. Never has the inner landscape been so variously described and discussed. It was an alien territory. It was – as I explained, commonly referred to by us as looking like a Toblerone – the transverse colon. He was ecstatic over that idea and all forms of chocolate were dredged up and became parts of the colon: the Roses green triangle, Curly-Wurly, the inside of an easter egg... We passed the liver - give us a wave! And detected all his recent abuses of that organ. We were underwater, pot-holing, finding caves over little pink crests of bowel. Like the inside of an accordian. We were – somewhat like the part of the Tracey Emin film “Top Spot” where a girl is lost in endless tunnels with a carnivorous predator spotted padding forward – we were in tunnels. Trains, buses (the bendy buses of course). He wanted to know what everything was, every little ridge and vessel and streak of tomato. I’d found a fellow enthusiast. We could have been a team. Only his colonoscopy – thankfully one twinge only at the splenic – was normal. He had no indication for one again in the forseeable future. Sigh. A perfect partnership briefly twinkled, and was gone.
Monday, October 09, 2006
Friday, October 06, 2006
We watched Emin's film, 'Top Spot'. It is an intriguing work which combines a variety of representational approaches. It features a group schoolgirls, first shown being interrogated (by Emin, off-camera) about sexual experiences. Although the girls look 'innocent', many have traumatic or shocking stories to tell. There are no male characters -- these are alluded to rather than realised -- although phallic symbolism abounds. Bleak scenes of the Margate beachfront are interpolated with scenes of Egypt where one of the girls apparently goes to try and track down her lover (although it is never clear whether this is a fantasy or not). The film has an unsettling climax which, like some of the preceding scenes, is shrouded in ambiguity.
The discussion after the film involved a lively discussion on role of autobiography in art, and what came across as convincing or contrived in the narrative. The sexualisation of the girls, portrayed as normative, was perhaps the most striking theme. Although the film was undoubtedly shocking, there was a sense of detachment because the viewer is never really drawn in sufficiently to identify with any of the characters. The camera technique never adopts any of the girls' point of view so the viewer is permanently in the uncomfortable role of voyeur.
Views on Emin's work in general were divided: some expressed grudging admiration for her ability to be so successful in spite of what might be perceived as a dearth of conventional artistic talent, others were infuriated by her inability to 'move on' from evoking her teenage experiences in her art. Is she brave to expose her life to public gaze -- the details of which many people find distasteful?
Emin's work does offer an insight into a particular slice of British life that is depressingly accepting of exploitation as unexceptional. The medical system doesn't even begin to engage with teenagers who seem to consider it unthinkable to submit to any kind of supervision. As Anna pointed out, the film and the issues it raises could help doctors not be complacent about the backgrounds of some adolescents. Ellen highlighted the awkward position of the teenager in the medical system: suitable neither for the adult ward nor the paediatric setting.
Thanks very much to Beth for giving us a theoretical framework with which to think about the positioning of the gaze in art in general and Emin's work in particular.
Sunday, October 01, 2006
As someone with a close relative who suffers from the condition, I was interested to hear Radio 4's Case Notes present a program on manic depression recently. The program gave some insight into treatment regimes, lifestyles and therapies which might help in managing the highs and the lows. I began to appreciate how the cocktail of mood-stabilizers, anti-depressants, sleeping tablets and anti-psychotics might help, if the sufferer remembers, or chooses, to take them as prescribed. Sufferers shared their experiences and talked candidly of what the episodes of mania and depression felt like for them. Mood stabilizers do what they say, that is smooth out the highs and lows. A sufferer I know personally told me once that the medication just makes her more acceptable to society at large. It numbs her and life is difficult - she misses the manic episodes when she felt on top of the world. You can listen to the Radio 4 take on things again here.
At the next meeting of the Purple Coat Club I will have the pleasure of introducing the work of Tracey Emin. Emin isn't part of my research but just one of those artists whose work never fails to engage my interest. Emin came up recently on this blog in a discussion around abortion. It struck me then that while her work does not portray medicine as such, it certainly engages with some themes and issues of interest. Abortion, rape, abuse, to name but an unpleasant few. Many have accused Emin of a kind of narcissistic self-interest in her work which goes no further than that. I've never taken that view myself for I believe she has much more to say. Anyway, on Thursday 5th October I will briefly introduce her work then show her film Top Spot which recently came out on DVD. Love her or hate her, everyone has a view on Emin, so I am looking forward to a live discussion after the viewing. See you there.