A Dry and Silent World: Part 3, ‘Translating the material into visual form’.

In this four-part series, four researchers – an Ear, Nose and Throat (ENT) Registrar, a Dentist, an Artist and a Professor – reflect on their experience working together on A Dry and Silent World, a multi-disciplinary collaboration between the Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial and Regenerative Biology, King’s College London, and freelance artist Emma Barnard, brokered and sponsored by the Cultural Institute at King’s. A Dry and Silent World is an ongoing project; works produced as a result of this collaboration will be exhibited in 2019.

In part 1, ‘A little like stepping off a precipice, but a lot like coming up for air’, ENT Specialist Dr Mona Mozaffari talks about pausing clinical training to pursue a lab-based PhD and participate in the King’s Arts in Dentistry Project.

In part 2, ‘Pretty experiments in the laboratory’, Dr Tathyane Harumi Nakajima Teshima writes about how it feels to be part of a team of scientists working with an artist.

In this post (part 3) Emma Barnard gives an artist’s perspective on collaboration.

Part four can be read here.

Translating the material into visual form: The Artist

The human narrative holds my interest as an artist and is the reason why I was compelled to work on the project A Dry and Silent World. Collaborating with researchers from within the department of King’s Dentistry I have drawn on previous experience working with Mike Papesch FRACS, an ENT (Head and Neck) Consultant Surgeon and his patients.

‘Unsweetened’ Digital CType Print 2018.
Image made in response to a discussion with an ex patient of Guy’s Hospital who has the xerostomia condition
Image ©Emma Barnard

So, how might it feel to live with xerostomia (the condition of dry mouth) or hearing loss? Thanks to my collaborators I’ve had the opportunity to discuss both of these conditions with patients. For xerostomia I spoke with an ex-patient of Guy’s Hospital, Philtold me that it was fifteen years since his cancer and subsequent treatment and yet his dry mouth condition had remained and would do so for the rest of his life. This affected his quality of life and meant that to enable conversation a bottle of water had to remain by his side constantly. His social life was also affected: as a biker he had often enjoyed a few pints and a curry with his mates, but now that was no longer possible.

The title of our project, A Dry and Silent World: Hidden Disabilities, alludes to the fact that clinicians may overlook xerostomia and hearing loss when treating disease or administering the medication that may cause them. Consultant in Oral Medicine at Kings Ms. Pepe Shirlaw explains that ENT doctors have no training in the mouth: the ‘throat’ part is understood as the larynx, throat and thyroid but not the mouth itself. I asked Ms. Shirlaw if xerostomia was on the radar for clinicians treating patients with cancer or dementia? ‘Dementia probably not, dementia doesn’t cause xerostomia, the drugs to treat it do i.e.: anti-psychotic, anti-depressants, anti-spasmodic, sedatives and anti-reflux. With cancer it is more so but low down on the clinician’s list of priorities.’

Discussing the effect of hearing loss with patients from St Thomas’ Hearing Implant Centre was equally unsettling. Both patients spoke of how the devastating impact that losing 80% of their hearing had rendered them helpless and without hope:

‘It was devastating, I was not born deaf, it just happened suddenly. I didn’t know how to cope because I connected to people through sound. The tone of voice had been taken away. This was how I communicated with friends and family. Felt angry, frustrated and sad’. DA

 ‘I couldn’t hear anyone that called me. My son was three when it started and I couldn’t hear him cry’. SP

Clinical Lead Speech and Language Therapist and Clinical Co-ordinator Sandra Driver, who works for St Thomas’ Hospital Hearing Implant Centre told us that she discovered that clinicians may not acknowledge and recognize hearing loss when treating dementia because ‘often they don’t know that there is hearing loss there’. In her opinion the main concerns of people who suffer with hearing loss are: ‘Mental health issues such as isolation, depression and difficulties socially’.

As an artist how do I translate this material into its visual form?

One of the joys of working with Professor Tucker and the team is that new doors are open to me such as the various departments within research at Kings. In our quest to print in 3D the organs that we are investigating we visited the Academic Centre of Reconstructive Science where Dr Trevor Coward, Consultant in Maxillofacial Prosthetics and his team discussed the incredible work that they do supplying facial anatomy to cancer patients within the London hospitals. We also went to the Tissue Engineering Department where we met with Dr Ian Thompson and explored the various 3D printing materials. With some working 3D prints of a salivary gland and conversations had with people that live with this condition I have been investigating how best to visualise living with xerostomia and hearing loss. I’ve also been working with my collaborators on visual literacy drawing exercises; Mona (Dr Mona Mozaffari) details one in her writing, Tathy (Dr Tathyane Harumi Nakajima Teshima) discusses another.

I’m looking forwards to further work developing the 3D prints including a 3D printed cochlear and working on subsequent images that will be produced as a result.

Emma Barnard MA (RCA), Freelance Artist working in medicine and medical education. emmabarnard.com @PatientAsPaper

A dry and silent world: living with hidden disabilities is a collaboration between the Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Craniofacial and Regenerative Biology, King’s College London, and Emma Barnard, brokered and supported by the Cultural Institute at King’s. In collaboration with:Professor Abigail Tucker, Dr Tathyane Harumi Nakajima Teshima, Dr Monireh Mozaffari, and Dr Doris Cuckovic.

This post is part 3 of a four-part series. Posts 1 and 2 can be read here and here, and part four can be read here

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