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Medicine and New Media: Report

Centre for the History of Medicine Summer School
University of Warwick 7 July – 11 July 2008
Report by Harriet Palfreyman

Bringing together postgraduates from a diverse range of fields, Medicine and New Media presented participants with an opportunity to engage in cross-disciplinary debate regarding the development of medical imaging, from the Renaissance to the present day. Mornings were spent in discussion with experts in the humanities and sciences, engaging with theories of imaging the body, questioning how meaning about the body and wider human experience are shaped by imaging, and addressing the ethical, social and political consequences of our desire to make visible every inch of ourselves. The afternoons were devoted to exploring the practical manifestations of these theories, through photography, digital anatomy and art.

Day One: Print and the Body in the Early Modern Period
The Summer School opened with a session led by Dr Sachiko Kusukawa (Cambridge University) and Dr Andrea Carlino (Institute de l’histoire de medicine, Geneva). Kusukawa provided a brief introduction to the history of the printing press from its inception in the mid-fifteenth century, stressing the technological, the epistemological and the socio-economic elements to the press. The debate touched upon how the mutability of images in this period fundamentally changed the relationship between image and text, begging further questions about the inclusion of images, their purpose and their didactic qualities. The complexity of the relationship between image and text also led to another, wider consideration in the work of studying visual culture, that, as Kusukawa proposed, the privileging of images can often lead us to overlook the importance of textual description as a medium able to evoke visualization.

After Carlino raised the subject of the presentation of the body in the illustrated anatomical atlases of the Renaissance, discussion moved onto the epistemological claims of images, particularly the function of idealized images of the body. In a profoundly individualistic medical cosmology that negated any idea of a normal body why did anatomical illustrations adhere to artistic conventions of displaying an ideal body? This led to queries about the presentation of the anatomical body inhabiting an environment as in the famous images in Vesalius’ De humani corporis fabrica (1543). Many anatomical images at this time mirrored memorable classical sculpture or contemporary erotic imagery, using them as memory aides for an audience learning about anatomical structures.

The afternoon session, led by Dr William Schupbach (Wellcome Library, London), presented participants with a talk on New Graphic Media in Medicine. With the printing press allowing for the rapid manufacture of books, new forms of easily reproducible images were needed. Schupbach described the reproduction techniques that sought to emulate the ability of watercolour illustrations to show colour and continuous tone, from woodcut to lithograph; he also covered some abortive efforts at producing the desired effects through mezzotint in the 1640s and eighteenth-century experimentations with aquatint. Discussion emphasized the process of making images as a communal effort, integrating artists, professional woodcutters or engravers and printers.

In the evening Professor Sander Gilman (Distinguished Professor of the Liberal Arts and Sciences, Emory University) gave the Summer School’s keynote talk Seeing the Insane: Representing Madness from the Middle Ages to the 21st Century. Concentrating on the interchange between surface appearance and its relation to inner, invisible mental states, Gilman moved between the realms of culture and medicine, from ancient to modern, showing iconic images of madness from the Magic Flute to Morel, from Durer to degeneration, charting the desire for visual representation of what can only be imagined beneath the surface. In his capacity of Visiting Fellow at Warwick’s Institute for Advanced Study (IAS), Gilman was present throughout the Summer School, contributing to events and guiding discussions.

Day Two: Photography, the Body and the ‘Other’ in the late 19th and early 20th century.
Molly Rogers
(Writer and Independent Scholar) picked up the chronology of imaging technologies in 1839, with the invention of the daguerreotype. In the mid-nineteenth century, the development of photography was laced with uncertainty over the application of such technologies. The question of what exactly a photograph shows became a central concern for Anthropology, a discipline maturing alongside photography during the period, as developments began to highlight a conspicuous tension between photography’s ability to reveal the surface but not the ethnographic depth. Discussion followed on the supposed ability of the camera to record the truth, to represent things objectively, revealing the multiplicity of factors that converged to create the ‘reality effect’ of a photograph, such as the indexical relationship of the photograph to the object and the replacement of a creative human hand with a chemical process.

Dr Mechthild Fend (History of Art, UCL) moved the discussion of photography into the twentieth century, away from anthropology and into the domain of the arts, while maintaining a focus on the relationship between photography and surface, in this case, skin. Fend discussed artists relationships with skin highlighting the work of Valie Export, Jenny Holzer and Santiago Sierra alongside the infamous 1993 Benetton ‘HIV Positive’ advert. Fend also dealt with the specific properties of different mediums such as the silhouette, the cast and the fingerprint, pointing out their indexical relationship with the body based on traces of contact.

The afternoon moved proceedings from the theoretical to the practical: participants were divided into groups, given a digital camera and a topic – ‘fluid’, ‘decay’, ‘surface’ or ‘mapping’ – and sent out into the wider university campus to explore the morning’s ideas. The end results were displayed for the duration of the Summer School in the Capital Centre foyer, providing visual expression of the Summer School’s exploration of theory in relation to practice, as well as a testament to the hidden artistic prowess of participants.

Day Three: Digital Anatomy and the Virtual Body
Moving proceedings away from the realms of history and into the modern medical imaging industry, Wednesday's proceedings provided an invaluable opportunity for communication between history of medicine and those experts working in the scientific disciplines who create our objects of study. The morning began with an anatomy lecture by Professor Peter Abrahams (Warwick Medical School). Following in the Vesalian tradition of visual demonstration and the use of images, Abrahams began with a quiz on a variety of medical images. In all cases participants were invited to guess what medium was being displayed, what view of the body was shown and what its cultural significance was. Abrahams then proceeded to conduct an anatomy lesson as he would to his medical students, using a PowerPoint presentation dense with images; textbook illustrations, moving digital images, MRI and CT scans and videos of cases he has found interesting, displaying the whole scope of medicine, from theory to outcome.

Following this whistle-stop tour of the human body, Pippa Chadfield (Associate Director and Head of Anatomy at Primal Pictures Ltd, London) introduced participants to the mechanics of creating some of the digital images Abrahams had shown. Chadfield demonstrated the origins of the components that make up Primal’s 3D computer generated model of the human body. This fully 3D-rendered anatomical body is built up of information taken from scans of a female cadaver, a live male elbow, the knee of a male cadaver and the female Visible Human, provoking questions from participants as to the viability of creating a ‘normal’ human body from disparate source material. Reminiscent of questions raised earlier in the week over the depiction of the idealized human form in the Renaissance, this discussion reminded us that the issues we deal with when studying images are issues often shared by their creators. Once again devoted to the practical, the afternoon session in the computer lab allowed participants to explore Primal’s 3D body, provoking discussion about medical knowledge and training based on such products.

The evening was spent watching The Cartoon Medicine Show: Films from the Collection of the National Library of Medicine, followed by the 1963 film ‘X’ – The Man with X-Ray Eyes. Introduced by curator of the collection Dr Michael Sappol (National Library of Medicine), The Cartoon Medicine Show featured a selection of early twentieth-century American medical cartoons, while ‘X’ is the story of Dr James Xavier, who, with his drug for increasing the range of human vision declares that he is ‘closing in on the gods’. A B-movie thriller about the perils of Promethean overreaching, the film provoked more laughter than debate, but was a further opportunity for attendees to connect in a more informal environment.

Day Four: Picturing the Modern Body
Thursday commenced with some brief remarks by Professor Gilman on the importance of interaction between historians of images and those active in creating the images. The morning session was to explore, in more depth and seriousness than perhaps allowed by the film ‘X’, the importance of X-ray and the imaging of the modern body. Dr Monica Dommann (University of Zurich) opened the first session with a talk on the impact of Wilhelm Conrad Röntgen’s 1895 paper on this new kind of ray. The talk charted the fortunes of the X-Ray after Röntgen, tracing various stages of its institutional expansion. The discussion following Dommann’s paper began with a recurring concern for the Summer School, that of the construction of objectivity, and moved on to a debate over the effect of X-Ray on other visual media, notably photography, as the allure of the invisible came to surpass the truth claims of the photograph.

Dr Michael Sappol, curator-historian at the National Library of Medicine, went on to deal with the place of images of the body in modernity. Talking first about the 1919 edition of the book Pictured Knowledge, Sappol demonstrated the radical change in visual culture that occurred between 1850 and 1900, a time of increased use of images in advertising, newspapers and public health campaigns. Going on to discuss the works of medical illustrator Fritz Kahn, who depicted the body as an industrial modernist utopia in works such as the 1926 Der Mensch als Industriepalast (Man as Industrial Palace), Sappol demonstrated how Kahn’s illustrations were typified by a visual rhetoric of modernity, using recurring modernist motifs such as rays, beams and wave patterns in his medical illustrations.

The afternoon session was given over to a screening of interdisciplinary artist Philip Warnell’s The Girl with X-Ray Eyes, a film Warnell termed ‘a performance encounter with Natasha Demkina’. Demkina is a Russian medical student known internationally as the Girl with X-Ray eyes because of her purported ability to see inside bodies, determining the internal pathology of those she scrutinizes. The film premiered earlier in the year at the Warwick Arts Centre with a live Theremin accompaniment, a screening of Werner Herzog’s Bells of the Deep and a talk by Steven Connor (Birkbeck) on the fantasy of acquiring X-Ray vision. Warnell was clear in the discussion following the film that it was not a test of Demkina’s claims, but focused on the moment of the encounter, the act of looking and seeing.

Day Five: Brain Pictures
The contemporary mania for localizing the totality of human experience in the brain was the subject of the last day. Professor Gemma Calvert (Engineering, University of Warwick) explained the genesis of fMRI (Functional Magnetic Resonance Imaging) from Roy and Sherrington’s suggestion in the 1890s that blood flow in the brain is linked to neural activity, to the establishment by Calvert in 1997 of Neurosense Ltd, a Neuromarketing Consultancy. Neurosense Ltd replaces traditional market research techniques by measuring activity in certain areas of subject’s brains when they are shown certain products. Discussion focused initially on the repercussions of the rapid development of this science, such as the enormous pressure to publish studies on MRI technology. Moving on from this, however, participants were also curious about the ethical dimensions of this procedure, such as its status as legal evidence.

Dr Fernando Vidal (Max-Planck-Institute for the History of Science, Berlin) addressed the problematic issue of MRI technology in the courtroom in a discussion focused on the ‘Cerebral Subject’; the notion that the only part of our bodies we need to be ourselves is the brain. Highlighting the pervading neuroculture we live in, Vidal pointed to various new disciplines emergent in the 1990s, the so-called decade of the brain, such as Neurolaw, Neurotheology and Neuroethics, to demonstrate our cultural emphasis on the brain as an almost autonomous entity, a metonymy for personhood. Vidal posited that the brain has now taken on the cultural significance that used to belong to the soul. We now see it as the entirety of ourselves, an eternal structure, immune to the aging process and able to ensure our immortality.

The defining feature of the Summer School was the high level of active participation: sessions were intended to work as dialogues between expert contributors and participants rather than formal lectures, facilitating the discussion of attendees own work in relation to the themes discussed. A welcome dinner and activity held on Sunday evening was therefore the ideal opportunity for participants to meet and interact before the programme officially started, meaning there was little hesitation in people entering into debate on the first day. Practical activities in the afternoons provided opportunities for attendees to interact in more informal settings, exchanging ideas in new environments outside of the confines of the traditional conference format. As the week progressed, free time became an ideal space for participants to informally present their own work and receive feedback from others and from contributors. Evening social events such as the film screenings and Thursday night’s dinner in nearby Leamington Spa provided a chance for participants and contributors to relax together, creating a sense of community and fostering a welcoming and supportive atmosphere during the daytime sessions.