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Excerpts from the Journals
February 1, 1998
well, here it is... Year 2... and I am about half way through my 2nd year of interviews with the Learning the Body students... they seem more confident, and not yet hardened...still eager, un-distanced from their learning... smart and bright and eager to lay their hearts and hands to medicine. Where does this myth of cool distance and detachment come from ??? certainly it hasn't begun to touch these students yet.
February 12, 1998
attended an obstetrics lecture this morning...the first lecture on this subject that 2nd year students had experienced...
The Doc brought 2printed medical forms , a pelvis, a rubber doll and a white kitchen garbage bag to act as the uterus...he muttered about the dropping birth rate, and the demand for perfection by pregnant women
he stated that in 1973 there were 6500 deliveries in St. John's and in 1995 it was down to about 2300
he complained about the rising costs of malpractice insurance... from 30000 going up to 40,000$
he said all you need to avoid making mistakes are these 2 forms... the provincial antenatal form and another labour chart...they are hospital forms... he did not talk about birth outside a hospital
when he described the S movement of the emerging baby, he held the pelvis in a prone position, implying an on-your-back-birthing position... he did not talk about warm oil and massage when he mentioned episiotomies...
he said " consent is developing into a nightmare", he described pregnancy for the patient as " a test of reproductive performance", he said " most women who come and see you are Healthy", he used the term "incompetent cervix", "progress of labour"... (where do we GET these terms ??? that construct pregnancy as performance ?)
he said " if you want to understand labour , you must follow the nurses, they know more about labour than physicians because they are there... we just pop in and do the delivery"
24 February 1998
driving home from "school", it leapt into my mind, that working with "people" in this context ( the great "frustration of "waiting for others", etc.) is not so unlike other parts of my practice as I had thought.... not much different than "waiting for the light", taking what nature presents you with, the gentle acceptance of not being in control...etc... and I wondered why one is so much more easily "frustrated" by not being in control of where one sits on others agendas...a double standard, indeed. and as suddenly, as I recognized the parallels... my "frustration" level dropped to almost zero... for really it is the same terrain, only populated with variables that , while not wind, weather, light, rain and time... are as unalterable and unpredictable... in so many ways it remains a miracle that I have found so much help and support for my work... ( on the other hand, of course... perhaps I am just becoming more accustomed to the waiting, and more grateful to the generosity of others...or perhaps I am just being "socialized" into the centrality of the physician!)
11 March 1998
... collected the first "comments" from Making Introductions... ranging from "GO TO Hell" to "Excellent work"... intend to enter them into the computer along with others that have been collected from the "boards"... but must admit to a thinner skin than usual... it "hurts" to be told to "go to hell" by a complete stranger... Whew... I wonder why I "invite" such "savaging"... certainly it is both humbling and enraging at the same time ( the mixed response of flight or fight !)... but on days like this, still weakened from the flu, I am troubled by the virulence of some of the comments, by the apparent close-mindedness, by how cranky my work seems to make some of its viewers... another comment today on Eye of the Beholder... re: "P.H. is getting $45,000 for this... with " not nearly enough" as well as " I would do it for $15,000"... so I took the bull by the horns and named my salary... so little understanding of how someone might feel in the face of such comments... be hurt, or wounded... I know I "asked for it"... and indeed, the positive and provocative comments seem to out number the grumpy ones... but I am forced to wonder whether I will "miss" such feedback when it stops. I do miss the 3 "c's"... curiosity, connection and compassion.
12 March 1998
long and productive day...successfully killed off the "self pity" and injured ego of yesterday's cranky comments. psychiatry classes most of the day, plus a quick shoot in the lab... lungs and anterior brain... and, of course the larynx... a small and innocuous structure, hardly "impressive" enough to produce the range of human voice... in such moments lie the sense of the miraculous... from such a tiny tube of muscle and cartilage comes the song of Pavorotti, Gregorian Chant, and the battle cry of the maddened Celt... as well as the seductive whisper of temptress and the soothing tones of the lullaby and late night story-teller... what a remarkable function in so unassuming a form..
April 20th 1998
...an encounter of potential importance happened today. Not in the school, but in the hospital...found myself johnny-coated in the ER with nasty allergic reaction to some still mysterious force. My body covered with wretched hives multiplying at a furious rate...I was the "patient" patient with the young female doc on duty in the ER. Returning with my prescription for the appropriate H-blockers, she brought in a resident named Michelle who wants help from the artist in residence with a video on sexual abuse... a conversation that went kind of...
"hey will you help me with my project ?", and " sure, ya wanna see my hives ????"
The really interesting thing about this encounter was the dropping of the doctor "mask", once they "recognized" me as part of their community...suddenly I lost the powerlessness of the nameless "patient" and became someone they "knew"... it was invigorating to the point where I could feel the adrenalin rush... suddenly I actually "felt better"... expected to be the "artist-in-residence" , albeit with nasty hives, rather than the "poor patient in room 4"...it was a moment where the established "roles", slipped, skewed, and suddenly we were, all three, equal women in a room having a chat about making videos !!!! an excellent moment indeed.
28 May 1998
finally...."back to school" full force. Past 3 days in the studio sorting, framing, re-organizing the studios for medical work... have begun some of the "phobic" objects for the Table of Phobias... leather sacs, covered with rubber.... have begun the hand-holding mould and will cast a "suite" of them in dental stone to "present" little "parts".... piece of mind, heart, eyes etc....expect to hang Hands in History in the next few days...
so nice to be "back on track"... It remains hard to do this thing only part of the time. One needs the income from other work, but longs for total concentration... can one do "total" in only three days a week ? That is about 150 days... between 6 and 7 months... not much time at all to go deep into such broad territory.
10 June 1998
later that same day... working on the black drawing of "listening hands..." to listen with one's hands, to touch with one's smile, to smell with one's belly, to hear with the brain... to touch with the voice... to listen with the hands... to look with the hands... to touch with one's eyes... rethinking the senses.... re-tooling the tools of trade...
the black hand drawing has a blank space below it... intended for tear off, but I cannot bring myself to eradicate that inviting empty space yet... it sings out for filling... for the "right" and complementary element... voices, perhaps, words of the patient... Doctor, I am frightened, Doctor, my head is spinning, Doctor, I have an acute pain in my heart...or perhaps a definition of "listening"... to listen...to pause, to be still, to embrace one's own silence in order to another's voice... the search for tonal nuance, to read between the lines of sound and meaning... to hear the unsaid...to absorb the sound and voice of another... to assimilate the meaning in ordered noise...
as contrary to "hear"... listen, attend, harken... to wait quietly for sound... to invite another's voice... to "watch" with one's entire body... to waken one's ears to the heard and the unheard, to be all ears... to lend an ear
later that same day...8:30 pm
just received a great phone call from Michelle, a 2nd year Family Practice resident. She is the one who came charging into the ER examination room when I had hives to ask if I would help her with a video on abuse.... oddly, when she called, I actually recognized her voice... we had a great wee chat and she and her partner are coming here for a meeting on Monday night around seven... their goal is to explore "what is healing ????... i.e. why are 50 year olds still hurting from something that happened to them when they were 4 ??? they want to make something for other family docs, med students, clerks, and residents... to motivate them, to enhance their understanding, and to decrease bias about survivors of abuse.... can't wait... it will be a great challenge to help them, and also IS part of my job as resident artist, ( at least I think it is, I think it is, I KNOW it is !!!!)
So... here it is, almost 18 months since my arrival in this place, and here, finally, is my first unsolicited approach from some one at the school... and this case a resident... a "real" doctor..... no less ...looking for a bit of help, support and advice. !!!! YES !!!!in my book, I call this BREAKTHROUGH !!!!
27 July 1998
finally... a full sweet day in the studio on the medical work... finished up the first three Figuring the Ground drawings... the listening hands... grids and label lines showing, Fig.1-3a all present and accounted for... lovely pieces, full of the mark making, measuring, "structural" marks from both disciplines... like little maps to the process of construction... revealing the "bones" , so to speak.
also hauled the Physiology of Female Defence out of the drawer and laid down the text... so am "clean-slated" and up to date with the Gynaeopedia. Moving on now, I think to Elements of Female Perception, The Physiology of Female Sexuality, and Selected Aspects of Memory Structure in the Human Female. With the Defence diptych done, that makes 18 completed panels in the Gynaeopedia...
28 August 1998
begin to settle in for the final run to 99... have spoken extensively with John Crellin, meet with the Dean on the 10th... Will try to prepare a session for Faculty Council to overview the residency to date and to solicit ideas/guidance, etc. for this final 6 months...spoke to HSIMS re: Michelle and Angela's film on abuse... if I can get the Dean on line, HSIMS will shoot it for us...CAMS will come in on post... need a proposal for Fac of Med support....god, I hate writing proposals for projects with no budgets !!!! How will we DO this penniless ???? no time for seeking outside funding... the docs have a deadline, and my help is useless if we can't bring it to at least rough cut in time for THEM. ...hung Keith and Ken's hands,(in history)... chatted with Andrew, who had left me a book on the history of American Obstetrics and Gynaecogoly... what a sweet gift.
13 September 1998
a student looking at the drawing of his hands, with hearts and text paraphrased from his conversation with me...says, " hey, I finally think I am starting to understand what you are trying to do...." What a rush !
he also inquired about what he had said to me on tape a few years ago... I must begin the transcribing... have put it off and put it off for fear that it would swallow me whole once started... and for those "purist" intentions of the earlier days of the body project... wanting it all to "be in place".. the "whole history" before I began to work with the material... Figuring the Ground has clearly broken THAT intention... and is really the first work to emerge "entirely" from the experience at the school... totally, both conceptually, and formally... from my direct experience with these dozen doctors in training. So... I MUST begin the transcribing... and if it swallows me whole... so be it. There is, I fear, a major bookwork brooding on those tapes... those hours and hours of tapes !
November 12 1998
... too busy, too busy... in the studio, on the film.... working on script, casting, looking for locations ...aaargh, I had forgotten how much time a film can take , especially with no "real" producer !
the little piece I made for Monte Carlo, quickly spun into a new series... from the Learning the Body imagery... small (22x30) works... tools of the trade/how to build a doctor type things... just spinning and spinning out... how sweet to be drawing again every day....transfers of body parts, tools, text from textbooks, all the stuff on which they "rely" to ply their "trade". Lots of drawing, lots of layering... such amazing material to work with... belonging, as it does, to those I know...The images holding all the history of our encounters...
December 10th, 1998
.. We shot Phil and Beth today... survivors one and 2 for the Mending film... Vera we will do tomorrow...I am suspicious of the HSIMS studio... fan noise, and electrical... may make sound problems, but Terry says no when asked if we are picking it up. We shot the doctor-patient scene in Bill's office... a week, 2 weeks ago ???? Camera "acting" as POV of doc on patient, and vice versa.... could be a cutting nightmare, but decided to "go for" the strong concept !!!! Bill was amazing in his willingness to bring real clinical experience to the "script"... another strong collaborator who "invested" himself in the project ... what a privilege to have his support and involvement ! He is so admired by students that his participation will add legitimacy to the project, the weight of a senior clinician is not to be under-estimated... and his generosity is remarkable. ...after tomorrow we will have all of the synch sound live action shot.... then after Christmas we will record all the voice-overs, then shoot Michelle's back for the writing on the body scene... slowly, slowly it builds itself into something that might be useful.
This is a wonderful way to leave the school, this project... fully collaborative... a team at play in the fields of purposeful meaning-making... interdisciplinary in the true sense... the artist as "voice-thrower".... as strategic partner in achieving the objectives of two young doctors...."scribe" to the "tribe".
January 15th, 1999
Have been recording voice-overs at CAMS... what a pleasure to work with these people.... both the volunteers who are lending their voices, and the technical staff who are great "crew" ! Fred H. has been amazing, flexible, and tremendously supportive... and at the drop of a hat recorded the "voice of authority" section in his deep, broadcast voice....After using Debbie McGee, it occurred to me that Nick's small boy's voice would be a tremendous addition to the piece... so I wrote a new piece of script for him, and he turned in a moving and professional "read".... having a child's voice will strengthen the whole thing, and I am thinking maybe we should "open" with it....
Looking bad for the edit here at CAMS... they are busy, heavily scheduled, and it seems like I might have to find somewhere else to cut if I am to meet the deadline for M and A's research presentation project... which is Now scheduled for early March.... AAARRRGGH... we aren't even finished shooting yet, and have no "post" facility confirmed.... maybe NIFCO will let me use the AVID.
Feb.26, 1999
We have a rough cut ready to high rez to beta !!!! and I started the AVID training course today... first of 5 days of training...god bless Lyly, god bless NIFCO, and god bless Angela and Michelle for inviting me into this project !!!! too much work to do to write here.... reflection can come later. We have bad sound problems, which means I will now need to do a Pro tools training course in order to re-mix the sound for the final cut. Will just have to keep "learning"...
March 3, 1999
Swallowed by the film/video work... which while not complete yet, passed a major test today at a screening of the rough cut to the Family Practice Research Day.... lots of people there... Michelle and Angela did their thing, and showed the video... I said a few words about the wretched sound, and more cutting to come...great response as far as I could tell... learned later that Ang and Michelle had been given one of four awards for "best" research for the project... so I feel good ! Truly, this stands as both the most radical and the most collaborative "intervention" I have made in the medical education community since I got there... helping a community meet its own objectives... rather than simply reflecting them back to themselves... too bad it is the "end" rather than the "beginning" of the residency... perhaps I should have spent more time with the family practice "types"... if there is regret in leaving... it lies here, in the paths that might be followed, the foundation that might be built on....
Comments on the residency, exposure to the artist, and/or her works
-Expanded my understanding of the importance of art in medicine. Improved the breadth of my teaching
-Re-affirms the "artistry" of medicine that has been so de-valued by the scientific method
-...I have to indicate that the artist in residence program is not adding to my appreciation of medical education, or of art..... the program has to be perceived as an unnecessary luxury or an inappropriate distraction.
-Some bitterness was experienced (by colleagues and grad students) when graduate students were displaced by the artist, who spent very little time in her office.
-I regret not having made better use of the artist during her residence. I was essentially a passive consumer of her work.
-Eliminate it.
-Scrap it.
-Broadens horizons. Potential to wake us from our dogmatic slumber.
-Anything that "broadens" our context is useful.
-I was not impressed with the presentation (to Faculty Council). It was crude and unprofessional.
-(It) Increased awareness of the relation between visual art, medical knowledge and medical attitudes.
-It's encouraging to see medicine "demystified". (It) broadens perspective, (provides) a refreshing look at medicine in an often conservative environment, to challenge our beliefs of ourselves, the human body, our experiences, and ultimately the view we will "impose" on our patients through the care we give them.
-1. liked her work, 2. thought it was worthwhile, 3. gave me something to focus on in addition to medicine
-Cancel (it).
-It prevents me from developing tunnel vision- i.e. helps me to view my role and daily activities beyond a diagnosis and a treatment... e.g. on a broader plane
-Has provided a useful "external eye".
-Some exhibits (by anatomy) are offensive.
-I feel the $$$ could be better spent- Ex. Equipment for labs, subsidies, etc., anything ! Cancel it ! I am sure the faculty can find a better use for the $$$$.
-The artist is trying to make us have a positive attitude ... to change to a better understanding. I have always had a good attitude towards the human body and the artist re-affirmed this fact. Book learning is not the only way, works of art help us to THINK, to LEARN.
-I believe the program has been a great success, and at a modest price.
-For the program, I felt that generally faculty did not recognize the resource in our midst. I felt that she (the artist) had a significant impact on the group of students who for the most part, are exposed to traditional theoretical and clinical knowledge... Her video, Under the Knife: personal hystories, added a creative dimension to the study of Women's Health.
-I believe it has led me to take a more human approach and see more of the personal aspects of illness.
-I think the money would be better spent towards health care.
-Brings a valuable dimension to the medical school in the humanities area. Currently not well appreciated or understood, but significant.
-Thought provoking, but still would ???? the $$$$.
Of the 32 questionnaires returned to the Dean's Office, to date, respondents answered as follows when asked if an artist-in-residence program should continue:
YES: 19
NO: 9
N/A: 4
For a quantitative assessment of the impacts as represented in the evaluation forms, or for an analysis of the successes and/or failures of the residency, readers must rely on the Canada Council's evaluative consultants, and the conclusions of the Faculty of Medicine itself.