No Obvious Trauma - Review

No Obvious Trauma is a play set in a mental institution in 1933. Two doctors, Dr Weaver and Dr Crawley go about their work, discussing patients and researching papers for their upcoming conference. They are young and optimistic, with hopeful aspirations for their asylum.
One day, a new patient, Ruth, arrives. She flummoxes Dr Crawley with her lack of speech, and he endeavours to investigate her condition.
However, when Dr Weaver sees her for the first time, it sends him on a spiral of memory, missed opportunity and lost love, for she is the very image of Charlotte, with whom he was romantically entangled whilst in Zurich in the past.

The play is a visual delight, combining dance, puppetry and simple sets with tea-dance music and clever use of the sparse stage - drawers become suitcases, wheels of a train, screens are doors, receive projections and provide sillhouettes.
The small cast provides the atmosphere of the echoing-corridor asylum nicely, with strong, slick performances from each actor. Ruth in particular gave a convincing performance of cortorted anguish and rigid fear. Her 'melting' during the course of the play is synonymous with her healing and improvement.

Ruth's condition is based on hysteria and within the play we see the susceptibilities of different personalities to emotional ties and classical themes, such as the over involvement of doctor and patient. I was struck by the dedication of the doctor to his patient, whether alluding to flaws in our modern system or merely praising the old traditional practices.

No Obvious Trauma is an ambiguous tale, with much left open to the imagination. The plot approaches cliche without crossing that line, and in that respect I felt the first act to be more thrilling and satisfying - the manner of explanation in the second act is a difficult plot sequence to convey.

The puppetry reminded me of the 1999 film Being John Malkovich. The use of light and shadow gave the performance a sinister edge, perhaps alluding to the power a doctor wields over his patient, especially given the context of a mental institution. Overall, this was a very enjoyable show, and I would thoroughly recommend it.

Skypecasts

Skype, a popular service that provides free voice calls over the internet, has been begun offering a new product allowing users all over the world to participate in real-time discussions with others about... well anything! The preview service, still in beta form, allows you to search for and join a conversation with people also interested in that particular topic. You can then voice your views after being handed the "microphone", all from the comfort of your own home.

This is a new move for the rapidly growing telephony giant, which is famous for its disruptive technology that brings its users closer together through free Skype-to-Skype voice and video calls, and extremely cheap calls to landlines and mobiles across the planet. The new addition to the Skype phenomenon is called Skypecasts, allowing people who download their free software to broadcast their opinions to listeners, like a radio show where you choose the topic you want to discuss.

Recently a number of Skypecasts about medical literature have been quite popular, including one about Geeta Anand's new novel "The Cure" about "How a Father Raised $100 Million--And Bucked the Medical Establishment--In a Quest to Save His Children". This was a popular Skypecast with listeners and contributors from the USA, India and other corners of the globe.

This new form of conversing with others has taken off: authors such as Anand using it to raise publicity for their work, and bloggers have started using it as a more direct form of expression and contact with their readers. Others have used Skypecasts to share their views about access to health care.

Perhaps this is a tool that could be used in the future by support groups, medical associations and even conference organisers. After all, it's free!

Travelling Apothecary

As part of the London Design festival, the Wellcome Trust has commissioned a one-day event - Travelling Apothecary - to be held in the Piazza of the British Library between 1000 and 1800 on Saturday 16th September. Stalls at this free event will offer cures for everything from 'network addiction' and 'litter guilt', to 'fantasy flings' and 'home makeovers'. You can find out more here.
Personally I'm quite drawn to Dr Bettler's Network Addiction Herbal Drink, sure to cure all blogging ills! Apparently Dr Bettler (aka graphic designer Alexandre Bettler) is currently working on a project about bread as a means of communication.

Ways of Dying

This is Marc Quinn's work Template For My Future Plastic Surgery (1992). It is used by the Tate to represent a half-day symposium, Ways of Dying, which will be held at Tate Modern on Saturday 14th October from 1400-1930. It will explore the relationship between life and death in contemporary cultures, drawing on the fields of art, philosophy, law, medicine, political theory, gender and cultural studies, biotechnology and environmental sciences. The program shows a top class field of speakers and papers. Oh, and there are drinks and music afterwards. You can find out more and book tickets here.

Baghdad ER

Showing on More4 on Wednesday night is Baghdad ER, an Emmy-winning documentary about the 86th Combat Support Hospital, a US army facility in Iraq. The 60-minute film is controversial. US army representatives refused to attend a screening because they thought it would engender negative feelings about the war. (As if any coverage of Iraq might engender a positive attitude.) The Army Surgeon General also issued a warning that if ex-combatants watched the film, they could suffer from post-traumatic stress. I have a feeling that watching this documentary might make all the 'gritty' medical and/or war dramas seem a pale shadow of reality.

I am in two-thirds through reading the Regeneration trilogy by Pat Barker. It is a tightly written and well-researched series of novels that focuses on the psychological treatment of soldiers in World War I. Barker uses the lives of the famous war poets, Siegfried Sassoon and Wilfred Owen, and their relationship with psychiatrist William Rivers as the basis for her books. She brilliantly merges biography and imaginative writing to explore issues of conscience and psychosis. I particularly like the snatches of poetry intermingled in the narrative. My mother was unavoidably my English teacher at our school for a while, and I recall with pleasure her teaching us the war poets. Rediscovering them in Barker's novels is like coming across old friends and finding them changed but the same somehow.

Yet another take on the war poets is to be found in Paul Fussell's fascinating book The Great War and Modern Memory. First published in 1975, the book documents in exquisite detail the irony of how the awfulness of war gave rise to beautiful and sensistive literature. It is an amazing exposition on how metaphors, far from being 'merely' figures of speech, engender concrete actions with often tragic results. Particularly insidious was the sporting metaphor which permeated discourse about the First World War. At the Somme, a captain offered a prize to the platoon which first kicked a football up to the German front line in the interests of 'a sporting spirit'. Fussell marries word, symbol and action in attempt to explain how the First World War is still surrounded by unwarranted romanticism. I can't recommend it highly enough.

Medical blogging -- what's your opinion?

It's time to overcome that summer lethargy and reclaim the work ethic! AJ and I are giving a presentation at the Medical Humanities Conference, hosted this year on 4 and 5 September by King's College London. We're talking about ... medical blogs. It seems sensible to sound out our esteemed readership by asking your opinions on the ethical issues facing medical bloggers. Is it fair that doctors can reveal nothing of their patients yet patients can say whatever they like about their doctors (as long as it's not libellous)? Should doctors be giving medical advice in their blogs? Are there any specific blogs you can recommend as being particularly good? We'd love to hear from you on these or any other issues pertaining to medical blogging.

Closer

'A Clinical Observer of the Human Carnival'

I've just seen Closer, starring Natalie Portman, Julia Roberts, Jude Law and Clive Owen. It's a film about the superficiality and need of human relations, played out with adultery and lust between two couples.

Clive Owen plays Larry, an emotionless, carnal dermatologist, who is unembarrassed to pursue what he wants, ruthless in his approach. He is countered by Dan, played by Jude Law, a novelist and journalist. Ultimately, Larry's unfaltering ruthlessness wins over Dan's romantic weakness - the alpha male succeeds in his primeval nature.

I was interested to note the themes of science versus literature, medicine versus humanities, clinical detachment and male versus female. The characters' roles in their lives - a photographer, dermatologist, stripper and waitress - all represent the superficial; all apart from Dan, whose book fails, meaning he must return to writing obituries - which are prewritten, again representing superficiality. His attempt at genuinity fails as he bases his book on another, without searching it out for himself.

Closer is a great film, very gritty, realistic and raw. There are some brilliant performances by a great cast, and it is another example of a mainstream film which manages to catch some of the age old issues in medicine.