What are the difficulties we experience in describing our symptoms to another? Thoughts of clinical imaging technology often spring to mind when the words imaging and illness are used together; technology such as magnetic resonance imaging, CT scanning, interventional radiology, endoscopy, and thermography are designed to help clinicians visualise the interior body as a living object. But long before these techniques can come into play in the narrative of illness, a different kind of subjective imaging takes place. The first step towards diagnosis is a recognition by us, the patient, that there is something ‘wrong’. The second is the struggle to pinpoint the problem we are experiencing using our, perhaps scant, knowledge of our inner body. And the third is to convey this knowledge in words that we imagine will aid another person – the doctor – to help us. The doctor’s intervention begins with their interpreting our words and re-imaging our condition based on the intersection of their knowledge and ours.
A medical sociologist that I had not seen, Professor Irmgard (Immy) Holloway, agreed to describe her physical self in words to me (via emails). I then translated her words into portraits of her, emailed the images to her, she responded with suggested corrections, and the process began again. In Imaging illness: imaging Immy, we mimic the act of telling that a patient engages in when visiting their GP – that of attempting to describe aspects of their physical being in words. My hope was that by exchanging information in words and reinterpreting these as images, we would identify potential problems in the act of extracting the information necessary in the first stage of accurate diagnosis – the initial telling.
As I write this, I have not seen Immy or heard her speak. Our relationship has been conducted solely by email. Via Immy’s written descriptions of herself, I try to portray her. While we engage in this activity, we reflect on the difficulty of describing physical traits to someone who can’t see them. I imagine this procedure as an analogy of the patient trying to make their complaint clear to the doctor.
Foreword of Workbook 2 (Nov.2011)
Our starting point was the creation of a portrait but why use portraiture in this context? Philosopher, Nancy Freeland, proposes that ‘a portrait is a representation or depiction of a living being as a unique individual possessing (1) a recognizable physical body along with (2) an inner life, i.e. some sort of character and/or psychological or mental states…[and (3)] the subject consciously presents a self to be conveyed in the resulting artwork.’*It seemed to me that all three of the conditions to achieve a successful portrait are also true of the patient’s visit to their doctor’s surgery. The effort required of the patient to consciously ‘read’ their interior world and to expose their inner state to their doctor is the lynchpin of this project. By distorting the usual artist/sitter relationship and creating a situation where the sitter represents herself to the artist through the medium of written clues only, I hoped that questions would be raised about the difficulties of conveying our inner selves during the first vital stages of diagnosing illness.
The natural format for the project has become an open-ended work-in-progress. As both Immy & I shared an interest in how meaning is perpetually created through the use of narrative, being transparent about the development of the work and making it available throughout the process of building seemed like the obvious thing to do from the outset.
One method of doing this is by making the research available as a series of workbooks.
As the description ‘workbook’ implies, these are not finished books. Each is designed to expand on the narrative of the previous version. After a brief foreword, the opening section describes my reason for starting the research, how I justify it and the method employed. These, together with the correspondence pages and the reference section at the end, are the only fixed elements as the workbooks are edited from one version to the next – everything else is designed to give a skeletal view of the issues raised by the early work and to outline the project’s development plan. Chunks of text are added, notes erased, ideas scribbled in, drawings refined and anything is liable to be moved or deleted as the elements are juggled to make sense of the research.
The first two are available here as PDFs. You can read them online or download them and continue with the work in any manner you desire! Of course, if you want to, you can purchase hard copies from online publishers Blurb.
(*Freeland, C (2010) portraits & persons, A Philosophical Inquiry. Oxford: Oxford University Press)