MJM MedTalks
Artists and Doctors (Part 1): How art helps us understand medicine

Introduction

00:00:11 Renée-Claude Bider (RB): Hello and Welcome to new installment of the McGill Journal of Medicine podcast series, MJM Med Talks where we speak with members of the Medical Community here at McGill and Beyond.

I'm Renée-Claude Bider, a Medical Student at the University of Ottawa and Podcast Associate here at the McGill Journal of Medicine. Today I'll be speaking with Professor Mary Hunter. Prof. Hunter joined the Faculty of Arts in 2008 after completing her PhD at University College London. Her research focuses on 19th Century French art and visual culture. Today we'll be discussing some of her work on the relationship between art and medicine and the impact and choice of art in hospitals.

As a note to listeners, we'll focus on visual art today, and images are links to the works we reference will be available in the show notes for this episode. Professor Hunter, Welcome to the podcast.

00:01:00 Prof. Mary Hunter (MH): Hello, thank you for having me.

Interview

00:01:02 RB: I'm delighted! So I'll start US off with maybe a bit of a deep dive on one of your works, but you wrote a book chapter for The Palgrave Handbook of History of Surgery about the depiction of surgery in 19th century art and there was this quote that I thought was really brilliant and maybe I hope encapsulates the conversation we'll have today, which was that at this time the scientific self was often seen as diametrically opposed to the artistic self, but that surgeons compare themselves to artists and believe in the art of their practice.

So, with that sort of unusual intersection in mind, I was wondering how you found your way into studying medicine and art, and how that sort of fit into your interest in history.

00:01:45 MH: Well, I think what interests me is that I don't think these divides are as sharp as people think. Lorraine Datson and Peter Gallison wrote a book called Objectivity years ago, and they are historians of science who are one of the first to really look at the historical and social and cultural construction of this concept of objectivity.

And in many ways it was always positioned historically as being separate* objectivity versus subjectivity, where subjectivity is always linked more to the arts and opinions and feelings versus objectivity, which was constructed more, as you know, cold and technological and you know, without bias. Where I think a lot of these Pictures from the 19th century make US kind of question this Sharp divide.

00:02:41 RB: I think that's interesting because from a medical perspective, one of the doctors that really inspires me is Atul Gawande, and in one of his books, I think Complications, he writes about how as doctors, we often overestimate the power of our intuition.

And- But at the same time, that intuition can lead to really almost miraculous solutions in medicine, so there is that interplay on both sides where we’re trying to present things as objective and also present our intuition as objective, but in reality, there's some subjectivity there.

00:03:15 MH: That's super interesting because I think now- and I've spoken, you know, with of course physicians, you know, who are either my own doctor or friends who are doctors or medical students, and I feel like people are a little more nuanced now when they think about what knowledge they bring as physicians to that patient-doctor relationship.

But if we look back, I think from people listening to tell you and I are looking right now at a portrait by a 19th century French painter named Henri Gervex, and he did this monumental, almost life size oil painting called before the operation with this incredibly long title Dr. Pean at the Hôpital St-Louis Showing his Invention of the Clamping of the Blood Vessels and a painting like this shows a surgeon in now what we would think of as a tuxedo and a group of men all standing around a bare breasted woman on an operating table with long flowing hair, and we see surgical tools in the left foreground and little spots of blood on the, you know, white cloth.

And what's interesting to me is that when this painting was shown, people saw it, and this is by 19th century, our critics were writing that this was his painting of utmost realism. And that the objectivity of that Artist, showing what the critics were accepting as a portrayal of real life, perfectly match the objectivity of that surgeon. So, you know, here the surgeon is shown speaking to the crowd as this powerful, knowledgeable man, yet everyone seems to be ignoring the sexy, young, unconscious woman who takes up, you know, the bottom part of the whole canvas.

So, I think this also- you know, historically speaking, this painting got me so fascinated with that mix between objectivity and subjectivity but also when you have something like this, where I kind of thought this is so much about performing that objectivity of modern scientific medicine, which was, of course, new at this time, that there is a kind of madness and craziness to this desire to look so objective. So, I think that kind of plays out also and the tensions that I'm interested in, and I think art can show.

00:05:48 RB: I- I think it's really interesting and I thought with this painting in particular, because it's so realistic, there is that temptation to almost take it like a photograph. And of course, even photography, there's some composition involved and I wanted to touch, as we go into analyzing these different paintings from a not at all arts background compared to you, I was wondering what are sort of the elements that you're analyzing when you're looking at a painting like this and maybe at the next paintings that we'll see?

Also for listeners, if they want to sort of play along at home and try to like zone in on these different elements before we get to them?

00:06:26 MH: Well, I think a painting like this is a great one because you start off by looking at it as a visual representation, you know, doctors, surgeons around a patient, you know, bright lights opening up onto the scene. So one is thinking about it, how it is composed as an artwork and what style it uses and all of these things, but also kind of where would it fit in the history of our well, it's part of portraiture, we know this is a recognizable man and It's a type of group portraiture, but it does new and kind of things that were new in the 19th century, like showing men at work.

We can see that he's not actively posed as would be an earlier portraits, you know, the time of portraits where families let's say, all stand together and lookout. This is really a man in action, showing modern life as it was. So, art historically speaking, I would tie this to theories around impressionism, this idea that artists should paint modern people in modern settings, in modern clothing, with modern gestures.

But at the same time, and this is what I like about being an art historian, there's a lot of detective work. So you don't just look at something like this, and because it's painted in a super realistic manner, say. “Oh, okay, this has to be truthful because it looks like Real Life.”

So instead with a painting like this, and this is where the history of medicine comes in, I started- I spent a lot of time in Paris, so I read all the art criticism about this painting when it was shown in 1887. But then I went to medical libraries and I started reading the obituary of this surgeon and reading his obituaries and then articles written about him. It turned out he was a very wealthy man. He was one of at a time when doctors were starting to make good money, when they were starting to be respected in society.

And that's when I found out that there was actually controversy on whether or not he invented these clamps. And that's when I kind of had that “aha” moment and I was like, “Oh, I get it.” He's a very wealthy doctor that wanted to be associated with these clamps, so the best PR is to get a very well known, trendy artist to make a huge portrait of yourself holding them, give the painting that long title saying exactly what you wanted to, and then he showed it at the annual Paris Salon, which was a huge exhibition with thousands of artworks on display but shown to thousands of people.

So, this is where we can also see a big painting like this, yes, it fits into the world of art, but it also tells a different history of medicine, and also as a type of advertising. So that's why when I look at something like this, you can analyze it pictorially, but you can also look at its history.

00:09:34 RB: I think it's so interesting. So that would be sort of Dr. Pean’s side. And in terms of the artist Henri Gervex, is there also some analysis to be done in terms of his intention when he's painting or the the impact of having also the opportunity to display his art on such a big scene in the way that he would compose or his subject matter?

00:09:56 MH: Yes. I think when we think about the genre of portraiture, it's sometimes thought about as an encounter between the artist and the sitter. So, when a portrait is commissioned, on the one hand the sitter is telling the artist how they want to look, but on the other hand, the artist's identity is also wrapped up in how they portray the sitter and one of the things we can always think about with portraiture, and I tell this to my students all the time, because especially in the age of selfies, whatever picture you take of yourself or a friend takes of you and you choose to put online, most of the time you make sure you look good.

So, portraits are about also looking good. So, when someone like Gervex agreed to do this portrait, he knew thathis identity would then start being wrapped up with Pean’s. So this idea that he is one of the utmost modern, successful men was certainly wrapped up in him painting Pean.

But at the same time, Pean choose Gervex, who was an artist that was very famous in the 19th century. So right now, if anyone happens to go to Paris and the Musée d'Orsay, people will know the famous 19th century French pagers, you know, Manet and Renoir, etc. But Gervex was one of their contemporaries, he in some ways was more successful than them. So, if you're at the Musée d’Orsay I always tell people, if they go to the 2nd floor, that's where a lot of the artists who are popular in the 19th century but not today, have their artwork displayed. So that's where you can see this one.

00:11:46 RB: Interesting. So, in a way, it's very much of its time. You have a very popular artist in, I guess, a portraiture culture that was widespread in the 19th century and with sensibilities to some extent remained in the 19th century because that fame didn’t transcend as much through the generations.

00:12:04 MH: No, not in the same way. I mean, you can think about in the United States, the Eakins portraits of The Gross Clinic and The Agnew Clinic. These are also huge, life size portraits of surgeons, and if you have the chance to see these in person, I mean, they are striking. Super kind of realistic, but also dramatic.

And because these are huge paintings and you can see this in the Gervex too, as a viewer, you're standing right in front of it and all of these are made as if you are in that audience. So, you know, if you think about these and The Gross Agnew too you are- the idea is that you are either a medical student, a resident or another doctor who's there witnessing this surgery. So, the way in which these paintings are composed do that as well.

00:13:00 RB: And so, you're witnessing this surgery, but also a surgery that's a bit of a fantasy, and maybe we should talk about the woman of the portrait, because as far as I know, in terms of draping techniques and things like this, you wouldn't have a woman who's essentially naked on the table surrounded by these men, so there's an element of fantasy also that maybe we want to address when we look at this painting.

00:13:24 MH: Well, I think so. Again, this is where it's wonderful to work, both in the history of art and histories of medicine. When this work- So, in the history of art you would say that a painting like this showing a young woman with her breasts exposed- you know, she's just covered up to her waist, unconscious - adheres to conventions of painting the female nude.

So imagine if you just transport this body and lay it on a wave in the ocean, you know, she would be a Venus, you know, so this isn't- Or, you know, floating in the water, she’s an Ophelia. But here what's interesting is she's put on this operating table, so in the history of art, you can see that this is maybe a modern rendition of a female nude.

But at the same time, this also led me to read what was happening in 19th century surgery, and this was when the painting was reviewed in a medical journal, and it said she would have been wearing a cap, her body would have been covered unless they were operating on her chest. So, here you can see that I think the artist also did this to get a crowd. And he was known for painting risqué female nudes, so this is when he could really show his skill as well.

I also think it's funny and it's worth mentioning, because I know sometimes medical students listen to this podcast, you'll notice that it's a younger man that in this is holding the naked woman's wrist as if he's taking her pulse, and he's holding actually a chloroformed cloth up near her mouth, so, this is also the age where anesthetics were first being used.

But what's interesting here is it's always the young doctor, often the intern or medical student, who has shown in close proximity to young women. And here you'll see again how his fingers are very close to her nipples, you know, so there is this sexual reading here. This makes me laugh, because there was also a novel in the 19th century Paris called Les amours d’un interne, you know, so “the loves of an intern” and it told the stories, you know, of an intern's relationships with patients. So, I mean, I think they're playing on these romances that we see today, I mean, they were in ER, they're in Gray's Anatomy, you know, the love stories in these medical scenes.

00:16:01 RB: Actually, I thought the exact same thing when you're describing this, that this interplay is still very much part of our culture. I think maybe it would be- this would be an interesting point to look at the next painting that I pulled up sort of in parallel. So as a contrast to the Gervex painting, this one is- it's a Henri de Toulouse Lorek that you have done quite a bit of writing about.

And what I thought was interesting about this painting, it's painted about five years later, so in 1891 to 1892, and it's also a painting of Dr. Pean, so same subject, but when I'm looking at it, the differences are huge. So this one, to me when I look at it, you have Dr. Pean, maybe a little bit older, a little less idealized who is looking at a patient. Unlike our last patient, this is not an idealized, romanticized patient at all. The skin tone is yellowing, we do have some draping, there seems to be a medical assistant, they're working in his mouth, and it's looking to me a lot more like what I would look at as a sketch artist working in a courtroom* It seems much more on the fly, done much more quickly.

But also has a very different sort of vision of Medicine, so I was wondering if you could tell me a little bit how this fit into the broader 19th century culture of painting medicine.

00:17:17 MH: So, Henri de Toulouse-Lautrec was a more avant-garde artist compared to Gervex. He was from an aristocratic family in the South of France and many like people know Lautrec who are outside of our history because of his physical ailments. He was disabled and people know him like that. He kind of had this celebrity persona in Belle Époque Paris.

His style was just completely different from what Gervex was doing. Gervex was painting big oil paintings that would be shown at the Salon. Lautrec wasn't. He was doing different types of things for himself, some for sale, so they're much more abstracted and sketchy. We can see his style is coming out of the nouveaux artists that we associate more with impressionism, so they have that sketchier look.

In this one- it's interesting because as you say Pean is almost cartoon like, he's this hulky figure he has it looks almost like a napkin around his neck digging into the patient, almost like he's greedy and hungry and eating.

00:18:29 RB: It's almost closer to an older version of a doctor, which would be more of that, like barber-surgeon. It's less refined compared to the portrait we just looked at.

00:18:40 MH: Exactly. And I think that history is still there. I mean Gervex is showing Pean as Pean wanted to be portrayed clean, concise, you know, the grand orator teaching all about surgery where this is not a commissioned portrait.

And so here these are playing with all the old stereotypes that we're still current at the time Lautrec was painting. So here you have the surgeon as greedy. There was always these issues around the surgeon because they- this fear that they took pleasure in cutting into bodies. You know, the doctors were making money from other people's pain. Doctors had access to bodies in a way other people in society didn't. So, there were all these kind of undercurrents that are playing out in the stereotypes that Lautrec is doing here.

Interesting to note about Lautrec is that are so many overlaps between artistic and medical education at the time* both doctors and artists focused on the human body, they studied anatomy and a lot of young doctors, medical students and art Students actually hung out together, and many were friends. So Lautrec, in the history of art, a lot of people have considered his relationship with medicine through his own ailments but I think it's more interesting to think about how he was involved not only just as regular people of his time were, but also he always lived with doctors.

And when he moved to Paris to establish his artistic reputation, he moved with a friend from his same town who was there to go to medical school and then later on, when that friend moved out, Lautrec’s cousin, who was also a medical student and then a young doctor, moved in with him. So, Lautrec and his cousin would go to Pean’s surgeries together. So, there was this spectacular side to going and watching the surgeon, and it was at these events that the Lautrec was making these kind of sketches that he later worked into paintings.

00:20:52 RB: I didn't really know that side of the Medical and art history and how combined they were at the time, and I guess that explains to me how Lautrec had access to Dr. Pean and then would be able to do much less flattering paintings.

So, you said that people look at Lautrec often through his illness when they're analyzing his art. But also, that he had access to these medical doctors through other means. But I was wondering, do you think that it does have an interplay - his own experience- with sickness and how he portrays doctors, or are those really two different spheres?

00:21:30 MH: I think an artist's biography has a role in how they're thinking and representing the world and their artwork, but I also think that their artwork is part of much a larger history of art and the conventions of art and what is going on at the time. So I don't think it's completely biographically driven.

Lautrec also did this painting Rue du Moulin, that is at the National Gallery in Washington, that shows two sex workers lining up for a medical inspection. Which shows, you know, a blonde woman lining up in front of a redhead, both in black socks, holding up their chemises, these type of nightgowns, you know, one of them showing her bare buttocks, and they are shown in a high-end brothel in Paris.

Some scholars have looked at this work and said, “Oh, this is incredible, this is a sympathetic portrayal of two sex workers waiting for a medical inspection, and it's sympathetic because Lautrec, as a disabled man, would have identified with these women”. I don't buy it because I also see this- I mean, he also paid to frequent sex workers. Sometimes sex workers were his friends. There was also fantasies around watching women in these vulnerable spaces.

You know, showing the work like this fit into certain avant-garde practices of showing sex work that we saw in many artists, Manet, Degas, later on Picasso. So I also think this is showing sex work is also quite conventional for artists and male artist at that time. So, I think we have to think of these kinds of works in both ways. We can’t see them as completely determining the meaning of a work.

00:23:28 RB: And maybe, for the listener, in sort of the broader scope of what's going on culturally right now and why these prostitutes would be here waiting. These were sort of government mandated gynecological exams that is painting where sex workers would have to get checked once a week and they're looking for syphilis. They're trying to reduce sexually transmitted diseases.

So, there's an interest interplay in this painting too between the artist in his study, but also a medical issue that was occurring in France in the 19th century that they were trying to curb.

00:24:03 MH: Yes, I think, well, that's the fascinating part of this is, yes. This is before the age of antibiotics. So, it was government mandated a physician or two would go into these brothels and check women for sexually transmitted diseases. If they were found to have something, they were sent to a type of prison hospital most often. So, a lot of these women would actually put makeup on to hide sores, they would do things to hide their illness so that they could keep working.

It's important to note that the men frequenting the brothels were not checked for disease and they were not checked when they went home to their spouses. So, on the one hand we can see this as a type of public health, but on the other one it was really one sided. One of the things that interests me in a painting like this also just when we're thinking about different things that art- can help us with thinking about medicine in different ways and maybe patient care, one of the things that this to me shows is it is this lineup of these women but I think it also invokes a type of empathy here because it shows that these women are waiting for that medical inspection.

You know what is going through their minds? what is going to happen if they get- they find out that they have something? You know, this at that time was a death sentence in the 19th Century. So, on the one hand, this appears as a type of, you know, flippant image of sex work in the 19th century, but on the other one, I think is profoundly sad. You know, even though it has this bright red background, I mean, we look up close, we can see the redheaded woman looking out at us, you know, kind of cold.

But I think they also can tell us a bit about experience in different people's experience. Even though that said, this painting is a figment of Lautrec’s imagination. We don't know if he was at the brothel taking this making this image, whether they were women lined up in his studio or he was using them as models, or whether it's just out of his imagination.

00:26:20 RB: It's again, it's that sort of interplay. It's a glass where you know, you can see into the pass into this moment in time, but it's a warped kind of glass and you're seeing it through Lautrec’s eyes and also through the style of the time.

00:26:32 MH: And I think this is another example where you have this overlap between the medical gaze and the artist gaze, and even ours is audience. You know, Lautrec was studying these bodies, he was depicting them, you know, in the same way that doctors had this diagnostic gaze looking and studying these bodies for signs of disease.

When if anyone's in Washington and has a chance to see this in person, if you get a chance to go up close and look at the women with the red hair's face, you can see that he's- it's kind of encrusted paint up near her cheeks, you know, this is disease skin. This isn't the idealized ivory smooth skin that we see in Gervex’s naked patient, which also points to the fact that the patient doesn't even look ill, you know, where in these women, you know, that you can see signs of illness. And I think the way in which we read them in that way, especially as they're lining up for a medical procedure that was mostly about looking.

00:27:40 RB: It's really interesting. It's again, it's that interplay between the artists and the doctor kind of doing the same thing. I also wanted to maybe touch on- We were mentioning how the woman in that first portrait is much more idealized. These women, by comparison, look a bit more worn down.

There's maybe something to be said about how sickness was perceived at the time, and maybe that some sicknesses would be seen as sort of grotesque, whereas you have also illnesses, I'm thinking of TB, for example, that are still very romanticized in the 19th century, and maybe that that could come to play in these portraitures as well.

00:28:17 MH: Yes, I think here, I mean, especially syphilis, it was also seen as a type of moral illness. So, it wasn't just, you know, that these people were victims and happened to get this disease, but rather in some ways also that they deserved it, that their behavior deserved it.

There's a medical text that talk about when bourgeois women, let's say, got syphilis. They had to find a way to make sense of it. On the one hand they knew, they likely got it from their husbands. But on the other, when they would then have children, let's say they didn't have many symptoms themselves, there was this kind of- now that we would think it is so bizarre, but if theories of genetics that someone in their past was a sex worker or a thief or an alcoholic and that this brought out syphilis and a newly born child, you know, so this is also this idea of adding morals to illnesses and not looking at just how one was transferred from one person to another.

00:29:24 RB: But maybe trying to justify or understand mostly incorrectly, but still try to place some kind of framework of understanding over why we get disease or why we get illness when the science maybe wasn't there to back us up.

00:29:38 MH: Definitely.

00:29:39 RB: Which we still do to some extent.

00:29:40 MH: I also see there's this idea of the social side of illness. I've read a book where a 19th century doctor was saying that a friend's daughter was about to marry a man that he knew had syphilis and who does he tell or not? You know, it's his friend's daughter, does he want to protect his friend's daughter or does he protect his patient's privacy? So some of these moral debates were there as well.

00:30:08 RB: Yeah, and some amount of stigmatization too. I know that in this painting of these two women standing in line and you touched on this before, there's an element of exactly that patient experience of waiting and I know that that's something that's interesting to you and that you've studied a little bit. So, if you want to maybe speak a little bit to that.

00:30:28 MH: Yes, I'm fascinated by the concept of waiting. You know that it in one way is a type of slow time but can be experienced in a hundred thousand different ways. So, for example, in the 19th century, it's especially interesting to me because you have moments of fast time that are emerging. You know, you think of the train, the invention of the train. It made the experience of travel so much faster. Space and distancing shorter. But at the same time, you had to wait for the train, so they had, you know, you would sell books, there were restaurants, there were things to occupy your time while waiting.

For me, medical waiting is something in particular, and I think we can all, we all experience it today. You know, when you're waiting to get a test result, it's a particular type of waiting. That's not the same as waiting for the bus. And that's what actually got me thinking about this work by Toulouse-Lautrec in a different way was to say, “How can we think about and have empathy for medical experiences of people in the past?” We can't know what they were thinking, we can know that it's not exactly the same as ours.

But at the same time, there has to be that fear that comes with medical waiting. You know, are we OK? Are we not OK? and I think that gets wrapped up when now when we talk about the waiting time to see a doctor, it means it means more to people, you know, it has kind of heft that just everyday waiting doesn't.

00:32:06 RB: Yeah, I absolutely see that. I think from a medical standpoint, you can have a lot of empathy for this idea that patients are- are sitting in the waiting room waiting for long hours, but at the same time you're also factoring in- or maybe this is me going like, but this is also a symptom of a medical system that needs reinvention and this is, you know, you get sort of carried away by the pragmatic factors and maybe lose the patient's experience in that analysis.

But at the end of the day, for a patient that's coming into the waiting room and waiting, you know, those eighteen hours sometimes at the emergency to know what's going on, maybe the problems with their medical system are not such a priority. And being able to empathize and seeing that that tension in art is a nice reminder that the patient is dealing with a very particular experience at that time, but also an experience that we can all sort of empathize with.

00:32:59 MH: I think this also goes back to our earlier discussion of objectivity and subjectivity. How time is experienced. I mean, on The one hand, you have time as completely objective, and in Medical Texts and pedagogy, it's really written in that way. I've done recent work on, you know, if you look at, Let's say pregnancy for example, in medicine, it's from conception and then it's by weeks and then at what point does a fetus move and at what point is labor and how many hours does labor take. And it's really in this very numerical understanding.

Where, how that's felt and experience, that temporality the more phenomenology of time is very different. You know, we all know, you know when someone says tell us when a minute's past after you can, when you watch your watch versus don't look at a clock and try to tell me when a minute's pass. Those are very different experiences. So, I think medicine, if we think about it through time as both kind of thought and felt is very different, you know, and I see that here.

00:34:07 RB: I think that's a great piece of insight. I'd like to move us on a little bit in time, and I pulled up another medical portrait for us that, this one is from the 1940s so we’re skipping ahead about 50 years and this one is a Barbara Hepworth painting, it's a from a Series called Hospital Drawings that she did in the 1940s.

If I was to try to, like, try my hand at describing it, what’s sort of kind of sticking out to me in this painting is that we have, again, an image from a surgical room but it's depicted sort of minimalistically. There's not much background, the patient is actually not really in frame, it's in monochromes with some grays and blues, and to me it seems a little more stylized maybe. And the doctors seem to lose a little bit of their personality or their identity. It's not- doesn't seem to be so emphasized on the individual. So maybe in contrast to what I've seen in this, I wonder what you see in a painting like this.

00:35:06 MH: Because you're a Medical Student, right?

00:35:08 RB: Yeah.

00:35:09 MH: Yeah, so this is interesting. You know, there's this practice of taking medical students to museums to describe artworks as a means of they- Some people think it makes them better at diagnostics, of actually articulating what you see. So, I would just say, yeah, here, everything that you said, I agree with.

But I'd also, you know, say that for the people listening, what we're looking at is it looks like two male surgeons, one with his back to us and the other facing us and then two nurses. So, one in the background and one lifting up a scalpel for the surgeon. I think here one of the things we can also notice just in terms of the history of medicine, the major thing, part of the reason why they have less individuality is they're wearing masks, you know. So, a lot has changed in surgery when we're looking here, these are gloved hands, masked faces. But it's quite different.

Barbara Hepworth is more known into her sculpture and these series of drawings and artwork she did when her daughter was getting bone surgery and she became friendly with the surgeon and I think again, if we're talking about this kind of artistic and diagnostic gaze here again, linking between the surgeon who was working with bones and the way in which her practice, I don't know if you've seen it, it's very- these big bone like sculptures. So again, this back and forth, we see these similarities between both professions. And I think that comes out here in the heaviness that she gives to her figures through these, you know, the line drawings and the hatching that we can see this back and forth between kind of the bones of her sculpture and the bones that the surgeons are working on here.

00:37:05 RB: I was also wondering, we talked a little bit about how- or you mentioned how medicine had really been transformed over these fifty years from a context of art history. I am assuming that there are also some trends in art that had changed over those fifty years and I was wondering if that sort of came to play in- in this painting?

00:37:22 MH: I think so. At this point, by the nineteen forties in the history of art, the history of art's already gone through multiple changes in almost anything goes visually. You know you have the integration also of ready made objects, you have all kinds of things. So, I think what's happening here is this is still with Barbara Hepworth is showing a representation of surgery.

What happens also we see in artworks that are not representational is when surgery, let's say, is invoked. So, Christine Borland is a contemporary Scottish Artist and a work of hers that I think is great, is you wouldn't know it was about surgery right away. It's, let's say, a photograph of a broken watermelon on the floor of this old stately building. And what she's doing in that work is I think it was an old manor house, it was transformed into a hospital for soldiers during the War. And here she's invoking the bodies of soldiers getting surgery through this broken over, open watermelon. So, I think in the history of art, we can see the way in which medicine is invoked in different ways, and ones that aren’t always easy to read as surgery.

So to bring it back to Hepworth, I think here we at least when we look at this, we know what it's about. She's giving us a narrative that we can read. It's not super abstracted, it's not conceptual, but certainly that happened in the history of art.

00:39:00 RB: I'm so glad you brought up that piece by Christine Borderland up, because I saw it when I was doing some research and I thought it was really compelling. I didn't know where it was gonna fit into the story, so I'm glad we got to talk about it for a little bit. So, I think it's interesting that we have this sort of now reinvention of how we can interpret art in surgery.

Looking at these different paintings, I found myself wondering if, because of the rise of photography, there was maybe less of a need or less of an interest in this kind of realistic paintings like we saw from Gervex. They sort of give us more of a freedom to play around with a little bit more abstraction. would that be an over reading?

00:39:41 MH: I- so you know what I think, in the world of art, yes, but in the world of medicine, not because one of the things we haven't talked yet is all the usual representations in medicine. So, when we might not call them Art proper, medicine produces tons of imagery. You know, and you think back to, let's say the age of doctor Péan, Dr. Péan actually had a huge collection of medical images and objects. He had many medical wax models of disease body parts.

And at that point those models were made from actual disease bodies. So, a plaster cast would be made of that body part, then it would be filled with wax, the plaster taken off, and then the Doctor would sit with the mouleur, the person who made the wax with the patient to make that wax model as realistic as possible. And this was of course before photography was in color.

And so now we would think of it so bizarre for medical students to go and study wax models of disease body parts, but in the 19th century, those could provide a more realistic representation than photography and unlike a human body where disease progressed and the patient died, these wax models could capture diseases at specific times. So then of course photography as it, you know, progresses is taken on in medicine. Medicine for hundreds of years had medical illustrations. That turned to photography, and you start looking at medical textbooks and they're filled with photographs. And then, of course, color photography changes things again. So, you also see how medical pedagogy changes as the technologies. Visualizing illnesses and bodies changes.

00:41:38 RB: Yeah, I mean, I think maybe it's a given now in our medical schools that we have cadaver labs, that we can see different organs, etc. But of course, those things all assume that we know how to preserve bodies, and they also assume that we have a culture where we- we feel ok with preserving bodies and then using them in these kinds of context.

So yeah, interesting to maybe get an insight into how that was done before we had these kinds of access, but we still need to be able to study bodies, organs and to see disease.

00:42:07 MH: And again in medicine, if anyone has a chance in Montreal to go to the Maud Abbot Medical Museum, it's a great example that shows real specimens next to wax models. You know, there's a real mix of ways in which the body was being represented, and so I think we have to think about the changes of how bodies and diseases were represented in the world of medicine and how it was done in the world of art. And often, there's a great intersection because for people, these worlds aren't totally separate.

You know, if people in medicine want to represent a body in particular ways, they're relying on artistic conventions. You know, the idea of the realism, let's say, that we looked at of Gervex’s early works, unconsciously a lot of people see that as being more objective and real life versus, let's say this Hepworth drawing or the Lautrec drawing we say. “Oh, it could have just been a sketch”. But one style or the other doesn't have a greater claim to truth. They're just different styles.

00:43:16 RB: And I definitely think it's something that I maybe find myself biased towards. Certainly I've seen these kind of Gervex paintings used even when we have presentations in class. Sometimes even if they want to mention something more historical, they'll pull up one of these paintings but you wouldn't see one of these Lautrec or Hepworth paintings pulled up in the same way. So, I think it's definitely a bias that still exists.

I'll bring us forward in time a little bit more, and we mentioned the rise of photography in medical use, but also in art. So, this is a movie by Christina Lammer called Hand Movies and I think it's actually from 2012 and I think you did a little bit of work on this. It's quite contemporary piece, so maybe we're losing our historical aspect here a little bit but I think that Christina Lammer had maybe an interesting comment on that- the interplay between art and a surgery, and I was wondering if you wanted to speak to that a little bit.

00:44:14 MH: Yes. So Christina Lammer is an artist and also a sociologist. And in here, her Hand Movies, she was taking short films of surgeons in the midst of surgery, but just showing their hands. So again, here we're moving surgery away from so far what we've looked at, we've known who those surgeons were. Here, we aren't given the name of the surgeon or surgeons. These are surgeon’s and nurse’s hands working together, and she talks about also, surgery is a more collective practice. This is very different from those early images we have where it's really that God like leading surgeon.

And so here she's interested in the interplay and communities of surgeons and all those who are involved in surgical practice. So, for her also, one of the things she's referencing here is a handwork by- I'm forgetting the name of the dancer- but who did these hand movies of when she was in a hospital bed and she's really showing the artistry of these hands. And so, I think they're interesting too.

This goes back to again earlier in our discussion where surgery can be both beautiful and scary, you know, a type of butchery. You know, here we also are seeing blood in the body and the body being cut up, but she also is filming it under this beautiful light. So we see how surgery always has this dichotomy and these tensions between, you know, beauty and ugliness, brutality and saving, you know, we see that very much, I think, in her films.

00:46:02 RB: Yeah. And- and choreography. It's quite a precise choreography that surgeons are running. As you mentioned, there's an emphasis on sort of the team element. So again, maybe we have a bit of a reflection of our trends in medical practice but also I think you wrote a little bit, or you quoted Christina herself and the article you wrote about this and her vision also as seeing herself as a bit of a surgeon when she's putting together these videos and cutting the scenes together.

00:46:38 MH: Yes. So, a lot of the time when you think about film and editing, it's referred to as that cut. And one of the things that Christina talks about is when she made these, rather than having it be kind of on film and then she would actually make cuts, she worked, she said, she kept referring to it as inside the camera. So that it wouldn't be as harsh and as violent, she would pause it.

And you know, so even these acts of the way in which her artwork itself, the way in which she filmed, she links to the surgeon and plays on this idea of the surgeon's cut, but at the same time as softening it. And this goes back to- and this actually we haven't talked about yet, but it's in most of the works that we've seen so far, the paintbrush.

The paintbrush was often equated with the scalpel. And you see it in Gervex, there's that almost a still life in the bottom left hand corner where the surgeons tools are equated with those of the artists. And especially in Gervex’s, I think is quite clever, where Gervex signs his name in red, which is the same as the blood, it's the same as what's on the tip of the surgeons tool. And then, you know, in other words, you can see this also in Frida Kahlo, who did many images of herself being ill, or with the surgeons who worked on her body. And again, where we see the- the scalpel and the paintbrush being equated.

00:48:10 RB: It'd be maybe a nice moment to talk a little bit more about Frida Kahlo.

Outro

00:48:15RB: And that's where we'll start the 2nd part of this episode, where we discussed the patient's perspective in art, the doctors perspective, and the role of art in medical settings.

This podcast was edited and produced by the MJM podcast team. If you've enjoyed my conversation with Prof. Hunter so far, reach out to us on Twitter or Instagram at mcgilljmed and be sure to listen to part two.