[wordup] Artistic Surgery

[Adam Shand]

Via: Ryan Wise <rwise at salu.com>

maybe something for wordup:  i really got into this interview with a
facial surgeon who had an artist paint portraits of his patients during
the surgery process, and found it to be a cathartic psychological aid to
both him and the patients...

From: http://www.newscientist.com/opinion/opinterview.jsp?id=ns23306

Meet the people shaping the future of science
 
About face

Imagine having a tumour the size of a cricket ball removed from your
cheek, your jaw split to correct a childhood deformity or your face
rebuilt using bone from your hip after an assault with a baseball bat.
Would having your portrait painted help you get over the trauma?
Maxillofacial surgeon Iain Hutchison had a hunch it might. So he called
in Glasgow artist Mark Gilbert, who spent a year at St Bartholomew's and
the Royal London Hospital painting his patients before, after and during
their surgery. The results will be exhibited at the National Portrait
Gallery in London later this month. Michael Bond hears how the
psychological effects on the patients exceeded all expectations
 
Why did you think an artist might help your patients?

IH: Firstly, I wanted a way of informing the public about what is and
what isn't possible with modern facial surgery. I couldn't have done
that with photography because it's too harsh. Secondly, I wanted to show
that people with facial disfigurement often lead full and rewarding
lives. The public has a major difficulty with facial disfigurement: they
either look away or they stare. It's a major barrier that has to be
overcome. Thirdly, I wanted to allow a portrait artist to paint faces
they would never otherwise paint--faces in transition, physically and
emotionally. Finally, I thought having the paintings done might have a
cathartic effect on the patients.

What did you think of the idea when Iain approached you?

MG: I was excited by it because I knew it would be much more highly
charged than anything I'd dealt with before. A lot of art involves
taking something mundane and creating something special out of it--think
of Tracy Emin's bed. But at the same time I was nervous. I worried that
I'd be focusing on the patients' deformities, and that the last thing
they'd want was to be painted. I thought I'd be focusing on things
they'd rather forget. I was also worried about the responsibilities I
was going to have to take on that you don't normally have to as a
painter.

How did the patients cooperate?

IH: You had to be careful how you approached them. For example, you
can't just say to a patient, "You've got cancer, and by the way I'd
really like you to have your portrait painted." I'd talk to them about
it after seeing them several times. Not a single patient I asked said
no.

Did anybody drop out?

MG: Two patients couldn't make their appointments with me and therefore
never started the process. But once we started, nobody dropped out. Not
only that, but I'd be making more and more demands on them as the
painting progressed and they were always cooperative and stayed with it
right to the end.

How did they differ in attitude to the people you usually paint?

MG: They were completely different. It takes a certain amount of courage
at the best of times for people to sit for a portrait. Quite often
people are genuinely offended if they think you've misrepresented them.
But with these patients that wasn't an issue. They were all so positive
about being painted. I realised I couldn't go off at too many artistic
tangents, but at the same time I wasn't going to flatter or sanitise. I
just tried to be as straight as possible. And even those patients whom I
portrayed in surgery with their skulls smashed in loved the results.

The project is about faces, so why are many of the paintings of the
whole person?

IH: I had told Mark that I didn't want bodies, I just wanted faces.
"This is facial surgery, you'll only distract from the process if you
show the whole body," I said. But he rewrote the rules and changed the
parameters. It happened because of Mazeeda, a little girl who came to me
when she was not quite three. She's from Bangladesh and her parents
don't speak much English. She had a huge malignant yolk-sac tumour,
which I took out.

She liked being painted?

MG: She loved it. She came to her first session after the operation with
a pink ribbon in her hair and wearing an amazing bottle-green velvet
dress and I thought, we're not going to miss out on this. So I did a
full-length figure and it gave me the opportunity to move away from the
mug-shot approach that I'd been following until then.

What is the advantage of showing more than their face?

IH: Mark managed to capture much more about the patients and demonstrate
their emotions. So you see Henry de Lotbinière (above, middle), the
barrister who has undergone 15 operations in 13 years for salivary gland
cancer, completely relaxed and at ease with himself, with half his face
missing. You see Mazeeda with a little Mona Lisa smile on her face. You
can see their emotions in a way you can't in photographs.

Did you get to know the patients more than you do your usual subjects?

MG: Yes, this was another way in which it was so different. I was
actively trying to create a strong connection with them because I needed
their opinion. That made the pictures richer. In many cases I got to
know them very well. Normally you have to be quite dispassionate about
the subjects you're painting, and when it comes to assessing whether a
painting is good or bad, the last person you'd ask is the model. With
this it was the complete opposite.

Iain, how close do you get to your patients?

IH: The nature of the surgery means that I have long relationships with
them. With cancer patients I'm reviewing them for the rest of their
lives. I enjoy having close relationships with them, I think it's very
important.

Is that unusual among surgeons?

IH: I can think of general surgeons who do form strong relationships
with their patients, though I'd say they were the exception. Being
professional and being dispassionate in the sense of being able to treat
people doesn't mean that you're cold and you don't show warmth and
emotion. It just means that when you come to the crunch of operating on
someone, you don't go to pieces emotionally. You have to understand
people in order to treat them. It isn't enough to say, "Right, you need
this operation and we're going to do it tomorrow." If I have to tell a
patient that their problem is cancer, in that moment their whole life
changes. You have to communicate, to see the person as a whole and not
as a walking cancer. Facial surgery is probably the most dramatic thing
these patients will have encountered. Any surgery is a terrifying
experience, but imagine surgery where you know your jaw is going to be
split, where you're having half your tongue removed, where you're having
bone taken from your hip and put in your face. These are huge
operations. Personally, I'd be scared if I had to have an in-growing
toenail removed.

Did that intimacy feed into the art?

MG: Absolutely. They were all very frank and open. But it was also to do
with the strong relationship that I was having with them. This was as
much to my benefit, because I wouldn't have been able to do the
paintings if I'd felt I might be upsetting them. I needed them to
reassure me that I was doing the right thing, especially since the
images I was dealing with were so graphic. I felt incredibly anxious
that I might be stepping over the mark, so that familiarity between me
and the patients was crucial.

How much of a cathartic effect did the paintings have?

IH: It has been incredibly dramatic, so much so that we got a
psychologist in to study the changes. I thought that seeing the
paintings might have some kind of cathartic effect, but I didn't account
for the effect that would come from simply sitting for the artist.

How do you explain that?

MG: They were in a safe environment, working on a one-to-one basis with
somebody who was incredibly interested in them. They found that
pleasing. They could talk to me about their experiences, and I could
talk to them about what it was like seeing them in the operating
theatre--what was happening around them, the music that was playing in
the background, and so on. They always asked about the other people I
had already painted, they enjoyed hearing about them. Obviously I had a
different kind of relationship with them to Iain's, and in many cases
they were telling me things that they hadn't told him about the
treatment. I could go to Iain and tell him about their anxieties.

How much did they want to know about what happened to them during
surgery?

IH: Some patients like to see photographs or a video of their operation
because they become curious after discussing it with Mark. The
psychologist says it's a kind of coping mechanism. It's the patient
saying, "I can hack this." Some patients carry around a photograph of
their painting and when they go into a pub and someone asks about the
scar, they'll bring out the photograph and show them.

It's one thing to have your portrait painted, quite another to have it
exhibited. How do the patients take to that?

MG: As far as they're concerned, the more people who get to see the
paintings the better. They seem to feel that the paintings are doing a
job on their behalf. Some patients don't like looking in a mirror and
they don't like looking at photographs of themselves, but they love the
paintings. They look at the picture of them painted during their
operation and say, "That's the lowest point of my life and I've got
through it." Because they feel that way about them, they're happy about
them being exhibited. It gives them a sense of empowerment: not only is
it going in an exhibition, it's also touring the country.

For more information see the Facial Surgery Research Foundation's
website at www.savingfaces.co.uk. Saving Faces opens at the National
Portrait Gallery on 27 February. Mark Gilbert currently has a solo
exhibition at Beaux Arts Gallery, Cork Street, London (020 7437 5799)

THE PATIENT'S STORY: ROLAND SCOTT

"It started as toothache, but when they took the tooth out and took a
biopsy on the abscess it turned out to be cancerous. It was rather
urgent because it was spreading across the roof of my mouth. The surgeon
cut around the nose and up right underneath the eye. He pulled all that
skin back and cut out the whole upper part of my left jaw and right back
to my ear and up to my eye. He had to put a brace in under the eye so I
wouldn't lose it. Obviously I lost my left nostril.

"When they asked me if I minded being painted I thought it would be good
for me, and I thought it would be good for other people, to make them
aware of what can be done. During the painting I used Mark like a
doctor, he was getting all my little troubles. I'd tell him about things
that weren't right, then I'd get a phone call from one of the surgeons
and it would all be sorted out.

"It was especially helpful with the radiotherapy. I had major problems
with that and with the mask I had to wear. I would tell Mark about the
mask, how I could hardly breathe out of it and how it came right down my
throat. You're lying on your back and the machine starts up and you can
feel a noise humming in your ears and you can taste burning flesh and
then you get the smell. It was horrible. They gave me some tablets to
calm me down. That happened every day for twenty minutes for six weeks.
I dreaded it.

"I wanted Mark to paint me in the mask because I felt the mask was an
important part of the process. When he did the painting I was standing
up with the mask on and I could feel the tension rising again. When I
look at that picture I say to myself, yeah, that's how I used to feel,
and it doesn't bother me at all to look at it. I've got the mask at
home. I couldn't leave it at the hospital. My grandson plays with it. He
thinks it's lovely."