Visual and Material Culture and an Old Anatomy School – Trinity College Dublin

Fiona Johnstone reports on the latest New Generations in Medical Humanities workshop, hosted by Trinity College Dublin in June 2015:

AUTOPSY 1. Seeing with one’s own eyes, eye-witnessing; personal observation or inspection. 2. Inspection of a dead body, so as to ascertain by actual inspection its internal structure, and esp. to find out the cause or seat of disease; post-mortem examination.
(Oxford English Dictionary)

Almost 30,000 people die every year in Ireland; of these, approximately 120 leave instructions for their bodies to be donated to medical science and education. Before traveling to Dublin for the fifth and penultimate meeting of the New Generations in Medical Humanities cohort, we were asked to view a short film about the body donation programme at Trinity College Dublin. Since the early 1980s, body donation at Trinity has been overseen by Siobhan Ward and Philomena McAteer, whose unusual role is both technical, involving the preservation of corpses destined for dissection by medical students, and interpersonal, supporting donors’ relatives through a potentially protracted bereavement where the body may not be returned to the family for burial or internment until several years after the death. Watching the film, I was struck by the pride expressed by future donors and their families at the thought of leaving their body to Trinity; the language of ‘gift-giving’ employed by both the donors and the young medical students suggested a system of reciprocity that engages the honour of both donor and recipient, and ensures that the cadavers are treated with respect.

This fascinated me, as the anatomised body has historically been associated with fear, shame and dishonour. In the eighteenth-century, the cadavers obtained for dissection were frequently those of criminals (see Hogarth’s 1751 etching The Reward of Cruelty, which shows dissection as the just if undignified conclusion of a felonious career); when the gallows ultimately failed to provide the growing numbers of medical schools with sufficient corpses, the 1832 Anatomy Act was passed, empowering the authorities to seize the bodies of paupers for dissections. Thus for a long period, the anatomised body was tainted with the stigma of criminality and destitution. A sense of shame may also have derived from the popular notion of the cadaver as the target of a sexualised gaze: the lascivious anatomist was a familiar figure of satire, as for example in Rowlandson’s sketch The Persevering Surgeon (c. 1755) which depicts an aged dissector leering over a buxom female corpse.

William Hogarth, The Reward of Cruelty (1751)

William Hogarth, The Reward of Cruelty (1751)

 

Thomas Rowlandson, The Persevering Surgeon (c. 1755)

Thomas Rowlandson, The Persevering Surgeon (c. 1755)

The act of looking at a (dead) body has historically been associated with shifting structures of medical knowledge and power. Foucault’s The Birth of the Clinic famously uses the practice of autopsy (the ultimate ‘triumph of the gaze’ according to Foucault) to signify the transition from an eighteenth-century clinical model based on reciprocal dialogue between doctor and patient, to a nineteenth-century one based on the visual penetration of the inner body. [i] As Martin Jay points out, Foucault frames ‘le regard médical’ (and indeed, vision in its widest sense) in particularly destructive and violent terms, building on the negative connotations surrounding ‘le regard’ since Sartre’s earlier discussion of it in Being and Nothingness. [ii] Indeed, Foucault never acknowledged the alternative meaning of ‘regard’ – to pay heed to or care for someone. Attention to the dual sense of ‘regard’ – to look at, but also to look after – might be crucial when considering the significance of visual resources, methodologies and discourses within the medical humanities.

The Old Dissection Room

The Old Dissection Room

Our first day at Trinity focussed on the compelling visual and material culture of Trinity’s old anatomy school, abandoned in 2011 when the department moved to the new Biomedical Sciences building. The former dissection hall and lecture theatre are decorated with arresting, unsettling murals of anatomised bodies and dissections-in-progress, painted in the 1950s by Cecil Erskine, Professor of Anatomy at Trinity from 1947 to 1984. Clare Guest (Italian department, Trinity) is currently researching the art-historical context of these murals, which are thought to have been projected from slides of images taken from Andreas Vesalius’s seven-volume anatomical textbook De humani corporis fabrica, published in 1543. Guest argued that Erskine’s murals were designed to operate within an instructive tradition where the decoration of the room was devised specifically to give its occupants visual directions as to how it should be used. In this instance, the écorchés in the dissection hall were intended to alert students to their own position in a long and noble tradition of humanist anatomists. This raised an interesting question in relation to visual literacy; to what extent would the medical students using this room have been aware of the art-historical or humanistic traditions informing these images? The question was answered by a member of the audience who had studied in the medical school some decades previously: his year group had merely found the images grotesque and unnerving, and had tried to pay them as little attention as possible.

The Old Anatomy Lecture Theatre

The Old Anatomy Lecture Theatre

When the medical school moved out of these buildings, a neglected treasure trove of papers, books, images and illustrations, medical objects and body parts was discovered. The collection is still in the process of being sorted and catalogued; any human remains no longer of educational interest have been collated and interred, and what remains should one day form the basis of a fantastic medical museum.

 

Visual Arts in Clinical Interventions and Medical Training: a mutually enriching relationship?

Our second day at Trinity brought the focus from the past to the present, with short papers by clinically trained researchers reflecting on the use of visual arts in medical training and hospital interventions.

Shaun McCann and Denis Roche described the success of the ‘Open Window’ project, an evidence-based study into the impact of arts interventions on quality of life for hospitalised patients. This study analysed the experience of almost 200 patients placed in isolation while undergoing stem cell transport; half the group were given a ‘virtual window’ in their hospital room through which they could view a series of canonical artworks, while the control group received no comparative form of visual stimulation. Participants in the intervention group reported significantly lower levels of stress on the day before the transplant, as well as reduced levels of depression and a more positive experience overall.

While the project was impressive in itself, this raised concerns about a potentially elitist approach to hospital-based arts interventions, whereby a particular type of cultural product (often ‘fine’ art or ‘high’ culture) is imposed on patients who may have a personal preference for alternative forms of cultural expression. This point generated some reflection on the ‘value’ of different cultural forms, and on who gets to adjudicate as to what form of art or culture is deemed ‘good’ or ‘appropriate’ in a specific set of circumstances. The issue was taken up by Des O’Neill, speaking on arts, health and aging, who reflected on the potential tyranny of replacing someone else’s cultural deprivation with a view of culture that they may not share.

As a humanities-trained scholar, it was fascinating to observe the medical humanities from a clinical perspective. All the projects discussed were intriguing and laudable, but the day left me feeling that the emphasis was very much on an instrumental use of the arts, placing the humanities in a potentially subservient relationship to medicine. A final paper by Brenda Moore-McCann discussing an arts-based elective module for medical students was perhaps a case in point. ‘C- don’t just look!’ is marketed to students as a programme that will sharpen their powers of visual perception and interpretation through exposure to artworks and art-making; the accent is on how art (and more broadly, the humanities) can make better doctors, rather than on a mutually enriching relationship between art and medicine. Little was said about how the arts and humanities might offer a productive challenge to certain aspects of clinical practice; this session was a reminder that the value of the arts and humanities as a critical toolkit should not yet be taken for granted.

 

[i] Michel Foucault, The Birth of the Clinic, trans. by A.M. Sheridan (London: Routledge, 1989), p. 203.

[ii] Martin Jay, Downcast Eyes: The Denigration of Vision in Twentieth-Century French Thought (Berkeley, Los Angeles & London: University of California Press, 1994), p. 392.

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