Polyphoney? One creative practitioner’s precarious privilege in the medical humanities

Still from "The isle is full of noises"
Still from “The isle is full of noises

I started this piece of writing months ago. I had just handed in a different blog to London Arts in Health Forum, when I was struck down by what can only be described as a bad evening. Not bad by any real standards, but I happened to be on my own, and to have just enough time a few things that I had been wrestling with to start surfacing. The blog had – broadly – been restating the case for creative and cultural engagement in relation to health, setting creativity and the development of the imagination in opposition to the (all-)consuming practices of late capitalism. But something about it was nagging about my conscience.

On this bad evening in Johannesburg, I was faced with the choice between writing some already-past-its-deadline music and shopping online and watching trashy imported TV on my laptop. (This might seem to be taking us down a strange alleyway – but stick with me.) Inevitably I went with the online shopping/trashy TV. Comfort watching. Retail therapy. Embarrassment compels me to point out that I didn’t actually buy anything, but I am nonetheless attempting to be honest here so I have to admit, AA-style, to being a slave to consumption.

Anyway this experience helped me understand what was bothering me about the blog: it was ringing false – not to my advocate self, but to me as a musician. I am sure if I’d had the steely determination and physical energy to go and sit at the piano I’d feel like a better person, but whether or not I’d just feel better is a moot point. Who knows? Maybe. Maybe I’d just feel tired and frustrated at having created nothing. Creativity isn’t always possible, isn’t always the answer. Certainly isn’t always desirable. Generally – in the very un-natural lives that we live – it doesn’t come naturally.

And as you get older – particularly if you aspire to identifying as a Professional Creative Person, it gets harder to persist. To feel the worth of what you create. The self-involved conviction of youth gives way to doubts about whether your voice, your story, is really the one that needs to be heard. What you create has to change with you of course, but as the ever interesting Francois Mattarasso said in a recent blog, ‘One reason why artists stop making work is because they cannot find how to speak as the person they have become.’ We develop habits with creative practice just as we do with accountancy and walking the dog. There’s a lot of bloody boring art out there as a result, and as Francois points out, a lot of people just stop when their ‘creative’ rut becomes irrelevant to their lives. We also stop because it doesn’t pay. It can feel unjustifiably self-indulgent to spend time writing a song that’s contributing nothing to the household expenses.

And – in the context of the medical humanities – creativity is fraught with the same tricky questions about identity and privilege as any other research, indeed if anything the questions are sharper – creativity (as a practice) purports to be for everyone in a way that academic research does not. Why should I, then, be afforded the privilege to bang on about my life experiences, or – even worse – translate other people’s life experiences?

This translation is ironically the more-likely-to-be-paid part of what I do as a musician. Tired of the sound of my own voice, and increasingly fascinated by the untold story of hallucinatory experiences in hospital, I started working on (other people’s) delirium in 2012. I interviewed people who had been through it, and people who had cared for them at the time, and wrote songs that interspersed their voices with my own, and other musicians’. I wrote a second piece about delirium in 2017. In between the two I won a commission from the Centre (now Institute) for Medical Humanities at Durham University to make a piece with people who hear voices – for a groundbreaking exhibition at the Palace Green Library in 2016/17. In this case, I ran a couple of workshops with six people who hear voices, which formed the basis of an animated musical film (“the Isle is full of noises”). I see this kind of work, broadly, as creative research into health – and I feel strongly there is much to be gained by developing our knowledge of health through creative processes as well as ‘conventional’ research.

I knew there had been some criticism immediately after I had been given the commission. Entirely validly, someone had suggested that while I might be a perfectly good ‘established’ artist, I had no experience with voice-hearing myself. (The Hearing the Voice team took the bull by the horns and held a discussion on “Who gets to speak about voices”.) I was taken aback by the word ‘established.’ It is certainly not how I would describe myself – for me it implies a regular income, a type of training and a portfolio I couldn’t claim. But I entirely see that from the other side I could represent a closed system – one that favours people with a certain kind of experience (facilitative?) over another (lived). One, moreover, that remunerates the prior experience and not the latter.

I had a very helpful discussion at the time with one of the Hearing the Voice advisors; we agreed that as long as I didn’t claim personal knowledge that wasn’t my own, there was some validity in using my skills to help shed light on a poorly understood phenomenon. I tentatively feel that there is space for us to talk about things that we haven’t personally experienced, that this can be a valuable act of imagination that supports better understanding. And (more daringly) I would suggest that there is a real connection between my own psychology and that of others – which is not to pretend to the same levels of experience or degrees of difficulty. But this is a difficult position to maintain. The flipside is cultural imperialism, the privileging of one voice over another, the reification of a certain kind of bourgeois creativity over any other. And none of this deals with the absolutely central question of money – who is paid for which bit of (creative) research into health. (Many of these questions are explored in Harriet Barratt’s recent blog for this site.)

I am ever more aware that a huge proportion of ‘art’ is not about invention or change, but about stagnation. I was in the House of Commons (NB commons) the other day and walked past a staircase full of twenty marble busts. All men, and it barely needs saying, white. We tend (inevitably) to venerate the arts in the world of arts-and-health, but it behoves us constantly to remember that art is not always the rebel in the room – at least until these lumps of stone are forever changed by the intervention of a quite different artist like Sethembile Mzenzane.

And in medical humanities, in creative research – as in all forms of research – there is likely to be a power dynamic between researcher and researched. I attended the Northern Network for Medical Humanities (NNMHR) Congress a few weeks ago in Leeds, where Angela Woods and Mary Robson presented on some of these complexities. Mary had given me a heads up that they might use Hearing the Voice project I describe above as an example of the sensitive ground we’re all on, but it was still odd to hear it come back at me in the context of a conference, to feel myself (briefly) the subject of the discussion. I found myself wanting to be involved in the presentation more actively, and simultaneously shrinking from the implications of being a very small part of the presenters’ analysis. It was perhaps a very micro version of how it must be to hear oneself discussed in research. Or to hear one’s own voice in a piece of music.

The arts can be empathetic media, for sure. Novels afford us an opportunity to see into others’ lives, as do many other types of art. But creative salience is no more or less democratic than any other form of power. We have to keep asking questions about the problems of art and culture. They are certainly not the good to the bad of medicine – we are all in this together. Esther Jones at the NNMHR Congress argued for the importance of speculative fiction as a way of imagining other possibilities for society, whether nefarious or idyllic, whether as warnings or as ways of opening up space for alternative ways of being with each other. Perhaps this is more what it’s about. Not that the created thing is the end-point, but that – like Mzenzane – it suggests what lies beyond, what can rise from. Its limitations – in terms of empathy, identity, skill, style, and so on – must be acknowledged, but the will to imagine, to reframe, is what makes it worth pursuing.

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