Thursday, 29 November 2018

Old silk

  The image above is one that is often with me when I see aneurysm repairs and was the subject of discussion with a surgeon recently. She described the stringing and disintegration of the inside of a diseased artery and I immediately could picture it and understand what the challenges were in trying to mend this. I spoke of the shattering of the silk and surrounding weak tissue and was similarly understood by her.
  A few weeks later a similar operation revealed all those problems writ large and with high drama. A complex operation with weak materials and then a rupture.Heavy blood loss ensued and a room of high emotion as the surgeons worked frantically, the scrub nurse worked frantically and likewise the anaesthetic team. I found that I was holding my breath as this 'piece of silk' disintegrated in their hands and I saw a miracle as they raised the Titanic.
  How does an expert work? they cope with deteriorating situations making difficult decisions in the moment. How do you spot invisible deterioration? How do you decide how far to go? How do you decide that you can't do anything, that the mend itself will do more damage than the tear. I know these decisions, they are material. How do you know when to cut your losses? How do you go from a planned small repair to a big unexpected one?There is no hindsight only expertise.
 All the while the other team members worked like bees, so quietly and efficiently. The clear liquid in the drip was changed for thick red, then clear red, then two shades of yellow. When the emergency was over it seemed that they all stood quietly and cleaned their antennae.
  I realised that pledgets are small promises made with each stitch.

Tuesday, 27 November 2018

In the moment

   I do not takes notes during surgery but rather allow the many new visual experiences to sink in as they happen. Afterwards I will sift through and do a quick diary which is often like writing down a dream; I don't always have a full view of surgery let alone an understanding of what I am watching from an anatomical perspective but I know colour and material and tool use. Above is an image of a piece of my work in progress at a rather confusing moment visually!  I know how to translate this but anatomy is another thing so below is an extract from one diary entry made about half an hour after coming out of theatre.

 ''Vertical incision so different, more solid layers revealed.....thick and compact.
Organs in detail-MANGO-finally named that colour! and pale blue pinks and organic egg yolk,'thought of 90's catwalk shows of bright colour clashes. Food colours in the abdomen, flame colours in the blood. Big crochet structure,uneven bobbles with thread capillaries and single cell clingfilm membranes.
(surgeon)opens out another fan shaped translucent structure with a fat pink edge and yellow centre and the light shines through it.
The cancer feels hard in the stomach lining, a suede beige, but hardly different to its' surroundings-a slight distortion but deadly. (I should point out at this point that once the tumour had been removed I was allowed under supervision to touch it).
Glimpses of pink things,smooth and shiny,translucent and dense......
The smell of someone's perfume mingled with blood stayed with me .A wild aromatic smell, otherness,strangeness,damp places of the world.
Theatre nurses,intense and watchful,quietly fetching equipment,listening.''

Monday, 26 November 2018

Torn lace collar


Recently I was given an old lace collar from the 1930's or older. It was all screwed up but still beautiful, an asymmetric design on fine lawn cotton with embroidery and a bobbin lace edging. There is a tear in the fabric at the front near the embroidery.
   It occurred to me that mending this would present parallels to vascular surgery and so I made these initial notes on examining it:
Mending Delicate Fabrics:
Prepare sequence of mending after assessment-washing, shaping, reassessing.
Tiny details almost invisible to the human eye which we disregard,detail was once more important and readable as a language of stitch.
Hand work that now looks to us like machine work so we don't believe it.
Tiny stitches in very fine fabric but no distortion from the needle despite heavy thread.

Raw edge to the cotton itself but so many embroidery stitches that finishing is unnecessary to stabilise the edge.
   After gently damping the collar with a wet cloth,(not submerging in water because the weight of water could be damaging) I carefully reshaped it onto a thick towel. It was not the asymmetric design I had thought but a symmetrical one that had lost a part.The true shape was now revealed as  rhomboid with an elliptical centre ,the lace still limply edging the whole. Once carefully ironed the original nature of the collar emerged as a 4D shape rather like a mesentery (organ of the digestive system) .....all frilly!!

  It is only after these observations that the job of mending the tear was the focus.

Saturday, 24 November 2018

Poached eggs

  In the art world and related universes much is spoken of process, the strange path by which we create something. We all have our different ways but in general it is almost more important to us than the final product.Our work then goes out into the world as a mystery to all but a few. These mysteries are formed because we have hidden the process which we do for a multitude of reasons. One example is in the recording of music.I enjoy hearing the sounds of instruments themselves as it tells me that the music is human and is being made. In recording the sound though it had been decided that only the 'music' is worth hearing and not the creak of a pedal or sigh of the musician.
  By hiding the process, for whatever reason, we begin to lose connection to our possibilities of creation.We begin to feel that making an object is something done by 'others'. We lose sight of how what we do in the ordinary world is connected to more mysterious worlds. This is where the work I am doing with Imperial has relevance. I try and see the parallel world that we inhabit and try and investigate what I find. Some of these investigations are pieces of work like the Textile Body but others are more private.
   I have mentioned how I find myself doing garden surgery when planting bulbs but to understand the experience of vascular surgery for myself  I undertook a stranger process. For several weeks I had a poached egg for breakfast and each day I had to dissect the yoke out before I could eat it.Each egg was slightly different in texture and fragility and every day I would gently cut the surface membrane of the yoke and then attempt to slide my knife underneath or around it to remove it. Each day was unsuccessful but each day I learnt the feel under the knife of a delicate material which was unknowable in any other way.

Wednesday, 21 November 2018

Look ye also

   I suppose it was only a matter of time before I had to think about death. Two years ago I visited two medical museums and was profoundly affected by the emotion stored within them. I still think of all those people in jars and I want to sing them all home.
   It was on holiday recently that I found the story of Joan Wytte and the story of her remains and how they were only recently interred after being kept for decades in a museum. Europeans have strange habits, we collect everything and put it in museums for educational purposes.We look but we don't see, we inter information but don't touch it. All the evidence of life is carefully documented, a brief flash in the universe whereas death is eternal, is it a way of thanking the dead?
   By looking and feeling we can learn what we didn't know there was to learn.I have watched two operations recently that didn't go well and for very different reasons.One was a scene of heroic endeavour to save someone, successfully, and the other was unexpectedly doomed from the start. I saw one life go to the edge and I saw another given its' sell by date. I found myself at scenes of true drama,quiet and intense and unknowable.The liminal space between life and death was palpable in both cases but after one there was relief at a life saved and the other the abject sorrow of helplessness in the face of the insurmountable. I heard medical staff saying sorry to the patient even though they were under anaesthesia.
   It is often at these moments that we learn what our purpose is, when we look we must feel.
The writer Denys Watkins-Pritchard (BB) found an inscription on a gravestone which says,

The wonder of the world,
the beauty and the power,
the shapes of things,
their colours lights and shades:
these I saw.
Look ye also while life lasts.

illustration by Denys Watkins-Pritchard (BB)
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