Stella Bolaki explores the benefits of using artists’ books in medical humanities education, and argues that the affective and sensory properties of the form allow it to mediate embodied experiences of illness more directly than literary narratives.
This post offers some reflections on a seminar on artists’ books that I recently taught for students of the University of Kent’s MA in Medical Humanities. The seminar’s aim was to explore alternatives to narrative representations of illness experience and, building on Fiona Johnstone’s Manifesto for a Visual Medical Humanities, to reflect more broadly on the contributions that visual and material culture can make to a critical medical humanities. Teaching took place in the Special Collections Reading Room of Templeman Library at the University of Kent where students were able to handle artists’ books from the Prescriptions collection. This material was acquired by Special Collections & Archives following the exhibition Prescriptions: artists’ books on wellbeing and medicine, which I curated with book artist and researcher Egidija Čiricaitė as part of the Wellcome-Trust funded project Artists’ Books and the Medical Humanities.
Laid out on the tables as students walked in for the seminar were a variety of artefacts that challenge conventional conceptions of the book: hand-crafted and stitched pamphlets, concertinas of different sizes and textures, flag books, textile and crochet books, altered books, books with drawings in ink or watercolour and book works accompanied by objects. In the case of Judith Alder’s Dossier: Constriction (2003), students wondered whether the yellowish, smooth to the touch, handmade object included was a vital organ or a tumour as they consulted the dossier that documents the object’s structure through a visual language derived from anatomical diagrams. More generally, the artist’s book is a perfect site for the kind of productive ‘ambiguity’ embraced in Manifesto for a Visual Medical Humanities. Emerging in the twentieth-century as a form of ‘intermedia’ that combines text, image and various methods of production, the artist’s book is an innovative genre. Its identity is continually developing as distinct from any of the artistic activities it draws on, such as sculpture, painting, printmaking, and photography (Drucker 2004), and remains vital in the digital age.
My students observed in practice that a multimodal form like the artist’s book expands understandings of the visual by involving the other senses, and as a result mediates embodied experiences of illness more directly than literary narratives. Being able to look closely and handle books makes them uniquely intimate and accessible compared to other art objects. In integrating their themes with their physical means of production, these books not only incorporate the patient-artist’s own perspective, but show how an experience, including those that are difficult to articulate in words, can be made visible or tangible. With its clinical look but meditative qualities, Lizzie Brewer’s Prescriptions (2015-16 ), a set of embossed prints that represent the amount of pills she took during the five years of her cancer treatment, poignantly captures her lived experience. Similarly, Anne Parfitt’s Diary of an Illness (2000-1) communicates the complex temporality of chronic illness through concertina pages that consist of repeated sequential drawings of a black ornamental bottle. Each image is an imitation of the previous, yet never identical. Even with books that place more emphasis on words, such as Martha A. Hall’s Voices: Five Doctors Speak, July 7-16 1998 (2001), we notice the fonts used to differentiate each voice: they become a visual code, suggesting the degree of compassion offered by each of the medical professionals she interacted with during her long illness.
Students shared their affective, sometimes visceral, responses to the material on display, which they did not merely attribute to the books’ content, namely experiences of grief, invisibility and terminal illness. Instead what stood out was the medium’s tactility and materiality – with Erin K. Schmidt’s The Unfinished Blanket (2016), which is about the artist’s much anticipated pregnancy that ended abruptly, we unwrap a book in the form of a baby’s blanket – and the corporeal metaphors on which books are constructed. In the case of Ashley Fitzgerald’s G. B. S. (2015), an altered book representing the effects of Guillain-Barré Syndrome, my students viewed the original book as a metaphor for the healthy body. While they imagined its pages as able to turn, the altered book is open yet ‘frozen’, similar to a body ‘relying on the inner organs to keep working’ (in Bolaki and Čiricaitė 2017, 35).
In paying attention to such ‘emotional dimensions of visual experience’ as well as to the ‘issues of power and representation’ articulated in these artists’ books, students were recognising that it is not what we read, but also how we read, that determines the potential of this work for a visually engaged medical humanities. Building on the key points outlined in Johnstone’s manifesto, we reflected together on the value of palpable, multisensory experience to a critical medical humanities. We talked about empathy and the provocations to biomedicine coming from some of the more confrontational books that don’t function in terms of Howard Brody’s conception of the field as a ‘supportive friend’. However, our discussion veered towards another concept, that of defamiliarization which reminded me not only of the work of the Russian formalists but also of Sara Ahmed’s discussion of queer phenomenology: of how we orientate ourselves to familiar objects like books and how interacting with artists’ books can create disorienting or unsettling experiences. Even though its form is not as disorienting as some of the others, Mary Rouncefield’s Mr Darcy’s Advice to the Hip Patient (2013) is an example of a ‘queer’ object/book. Like Rita Charon’s ‘parallel chart’, but this time written from the patient’s rather than the doctor’s perspective, it makes medical culture strange by using playful illustrationsto offer an alternative take on rules designed to help patients avoid dislocating their replacement hips.
Such defamiliarizing function is not instrumental: it is not merely an educational or humanising intervention, but can have more agency. On Innards (2015), a collaborative book by Amanda Couch, Andrew Hladky, Mindy Lee and Richard Nash, which embodies through its multitude of folds the intestines, is not limited to the illustrative. As Couch has written, digestion ‘stems from the word “digest”, which can both refer to an arrangement of written work; and to the processing or making sense of knowledge and experience, as well as to break down and absorb food’ (in Bolaki and Čiricaitė 2017, 28). By establishing connections across fields such as gastroenterology, virology, the medical humanities, cultural theory, poetic practice and yoga, and by allowing us to experience them through its intestinal/archival form, On Innards is an ambitious experiment in multidisciplinary entanglement. As I have argued elsewhere, artists’ books can help reignite a sense of wonder and mystery when it comes to confronting the body’s materiality. They can emphasise the aesthetic and imaginative elements of illness communication and generate associations that move beyond strictly clinical frameworks. Students commented on how the choice of wire in Sue Hague’s crochet book What Lies Within +Vigilance (2015), for instance, conjures the hardness of a breast cancer tumour but also references sturdiness and resilience, complicating the medical metaphor of the ‘body as machine’. Similarly, the body experiencing loss of consciousness becomes associated with stories of enchanted sleep in Julie Brixey-Williams’ Rosebud (2004), a sculptural work that reimagines the breathing patterns of a subject under general anaestheticasa series of flow-loop waveforms . These calligraphic traces were created by an anesthetic machine as the artist performed an extended reading of The Sleeping Beauty. Emerging from the artist’s residency at The Association of Anaesthetists of Great Britain and Ireland, this creative collaboration attests to the ‘shared set of interests’ between the histories of medicine and art.
The seminar concluded with several challenging questions: what does it mean for work presented in a ‘democratic’ medium that has been described as an ‘alternative space’ to the art gallery to be preserved in a university’s archive? Even though the Prescriptions collection is not a unified singular entity, does encountering it in the context of a medical humanities course exert certain demands or create particular expectations? Artists’ books produced in the 1970s and 1980s that addressed the personal experience of diagnosis and treatment were not situated within a medical humanities context. For some this may constitute a missed opportunity to engage with these voices and the alternative knowledges they generate. While the Prescriptions material is explicitly positioned within this context, is there a danger that in emphasising that dimension, these books might not also be understood as works of art? Many students pointed to the difficulty of delimiting the boundary between private and public or between art and therapy, and reflected on the ethical and other challenges this difficulty, and the special intimacy of the artist’s book form, present when deciding how to critically engage with it. Given the overlap between patient and artist exemplified in this work, are the categories of patient and artist in need of redefinition? Such complexity is not restricted to artists’ books, of course, but demonstrates the need for more sustained engagement with visual materials within this field.
Acknowledgement: I would like to acknowledge the seminar contributions of the students of ‘Medical Humanities: An Introduction’ and the support of Special Collections & Archives at the University of Kent in writing this post.
Stella Bolaki and Egidija Čiricaitė (eds). 2017. Prescriptions: Artists’ Books on Wellbeing and Medicine. London: Natrix Natrix Press.
Johanna Drucker. 2004. The Century of Artists’ Books. New York: Granary Books.
Stella Bolaki is Reader in American Literature and Medical Humanities in the School of English at the University of Kent. She is the author of Illness as Many Narratives: Arts, Medicine and Culture and Director of Kent’s MA in Medical Humanities.