The Touch Test

 

This week Prof. Roger Kneebone and I were featured on BBC Radio Four's programme 'The Touch Test'

https://www.bbc.co.uk/sounds/play/m000dfp3

talking about the Textile Body and about touch in surgery.

(To listen you may have to sign into the BBC's i-player service).

Scarred

  Scarring is a problem for skin and fabric, once cut or traumatised it will never be the same. Some heal very well, almost invisibly, some do not. As a prompt to discuss what we know about someone before we operate on them I made this small velvet quilt for the Textile Body. Following its format of nine squares I took my inspiration from 18th century.whole-cloth quilts and used silk velvet to illustrate the problem. It is a material that is both beautiful and easily damaged.

  Scars on the skin take many forms but keloid, hypertrophic and contracture scars are particularly problematic. In appearance they can be highly raised from the original site of damage or incision, dense and overgrown or having the appearance of pulling the skin surface in multiple directions.

 Used in conjunction with another layer that looks at fragility in ageing skin it can be used to explore different aspects of touch and how we understand 'wrongness'. It has already been used to engage young adults interested in going into medicine at a yearly event at the Wellcome collection as part of the Saturday Studio programme.

Tumourous

 Quite simply I was asked to do a cancer layer for the Textile Body. The format therefore would follow the grid of nine textile squares which could sit on top or amongst the other layers in the 'Body'.I worked with surgeons who deal specifically with cancers and was given access to theatre and to tumours that had been removed.
  However it was not beyond my imagination to know what was was wrong when it came to a piece of silk so I chose this piece of tabby coloured antique silk. It is very high quality with a very smooth surface and in some places the silk is discoloured. This was my queue for the first signs that something is wrong underneath. Snags, puckers and adhesions are not desirable in silk and  not in humans either. On the reverse of each square is a pocket in silk mousseline, the finest silk available.It is both very sheer and delicate. Inside each pocket I placed an object which was uncomfortable in colour, texture and usually juxtaposition thus being contextually 'wrong' too. They could all be felt through the silk.

   Mostly it was hard to guess what they were before seeing them but when medically examined the diagnoses were largely the same. ''Unnatural mass'' and ''this is the sort of thing where you have to control the expression on your face'' were two early comments.

   One though was designed to be unseen, a gist (gastro-intestinal-stromal-tumour). I had been allowed to examine one after surgery, it was like a malevolent brain with its' own blood vessels and a texture of cauliflower and dense goo all in a membrane. They can remain benign unless ruptured so I imagined the monster lurking within and recreated it.

   Two rubber finger monsters and a plastic flower did the job, all compressed into a silk pouch and secreted between two layers of pleated silk pocket. It can be removed by untying a white ribbon and carefully sliding it out from the pleats.
   Many thanks to surgeons Chris Peters, Tamzin Cuming, Sam Gallivan and Roger Kneebone  for their advice on this piece. It has already been used to engage young adults interested in going into medicine at a yearly event at the Wellcome collection as part of the Saturday Studio programme.

Underlayers

 

 
  I was recently approached by an anthropologist, Kaitlin Burton, to study my work with a focus on the Textile Body. There was a visit to my studio and I was observed at work out and about!
  The result is this website with her observations about me and the digital legacy of this particular piece of work (please wait for the site to load).

https://kroseburton.wixsite.com/underlayers

Textile Body part five: The unknown

  It takes a while to get to the site of the operation but after passing through the labyrinth of the body we arrive at the cramped confines of the organs.Tucked away in the core they are mute and mysterious, their internal structures hidden from view underneath the smooth surface. Here is where the tiny stitches will be, the micro movements made with trained hands, the millimetre precision judged.

 It was with some interest that I found that different organs are tougher than others due to both age and structure so I chose three different types of fabric which would behave very differently. Not wanting to simply make bad anatomical soft toys I chose instead origami to represent the complexity of the body.I have loved the folded fortune teller since a child, the tactile experience of the folding sequence and then finding that you have made finger pockets and fold out layered areas to write messages on.

 In fabric they take on more mystery so I chose first paper silk which as its' name suggests behaves like paper and takes a fold very well.It is incredibly lightweight and yet resilient. Inspired by a conversation with a paediatrician I chose it to represent neonatal organs. I also chose a coarse weave linen and a slub silk.The latter was heavily frayed and after completing the folding  these were the ones that I chose to squash out of shape to show damage.

  Inside I have embroidered samples of stitches that I use in my raised embroidery and lacemaking work. The linen organs all have variations of buttonhole stitch whilst the silk organs have examples of picot stitch, french knots, cup stitch and, shown here, needlelace.

   Each of these stitches is relatively easy to work on their own and on flat fabric but when they are grouped together they present lots more difficulties.The needle is more likely to hit other stitches as you sew and your thread becomes spiralled and catches on the fabric.These are the same challenges as minimal access surgery both in the technicality of the stitch and of handling several materials at once.

Textile Body part four: Noughts and crosses

  My area of observation in surgery has so far been for vascular surgery. I understood that there would be examples of very fine stitch work but had not fully considered how it was that you arrived at the area to be mended. It was the detailed sequence of the route into the body that inspired much of this 'body' that I have made.

  Watching several surgeons working at the same time I was aware that they don't just have to stitch but plan and negotiate physical space, both within the confined area inside the body but outside it too.

Around the patient there are at least three surgeons plus a medical student and the scrub nurse...and sometimes me! The surgeons must both negotiate elbow space around the operation and assist each other with tight manoeuvres, referred to as 'following'. The sequence they must follow into their target area has already been planned and in some cases marked out on the body after studying scans and case discussions.

  The image above shows how I have divided up some of these skills; on the right the woven materials of muscle and fascia and artery with their attendant material challenges to negotiate in order to get at the problem. On the left a game of noughts and crosses in fine organza.

  There is a style of quilting called trapunto which was once very fashionably worked on sheer fabrics.Patterns were hand stitched as double rows of parallel stitches on organza.Through the transparent material you could see cords impossibly threaded through these channels but with no apparent entry or exit holes.The fineness of the material allows for no mistake not least because it can be easily damaged.

  My version has tubular ribbons threaded through the pattern of '0' and 'X' variations, each slightly different to illustrate subtle differences in the challenge of threading them through. The trick is planning and understanding your materials;where to start? what tool to use? how far can the material be pushed and does it have hidden qualities?

 It seemed to me that a thought experiment was just the thing for this layer in my 'body'.

Textile Body part three; fragility

  This third post about this piece looks at how fragile some materials are. I was fascinated by how parts of the gut are lifted out of the body during open surgery to give the surgeon better access to the mending site beneath. The living structure is cared for whilst out in the open and still functions despite what is going on around, in fact it moves.
  This led to some interesting discussions with surgeons as to the nature of the tissues involved and I began to understand the similarities between these and certain fabrics that I know. One of the most extraordinary is connective tissue and the mysentery. This tissue type has more poetry about it than any other as it is changeable and elusive and somewhat mysterious. It webs its' way through the body and reveals itself under a microscope as dewy, fibrous, filmy and like organza.
  Throughout this piece of work  I have represented it in four ways;as clingfilm around the 'spine', as silver lurex stitches between layers of 'skin', as wide organza ribbon weaving through the 'muscle' and as layered organza in the gut. This last one is featured here and is the one where I took the most artistic liberty with the form!
  My elastic band lucet braid gut was tested and approved by a colorectal surgeon and I added in different thicknesses of braid as directed. There are also areas of damage to it which can be 'repaired'. But then I felt that it should sit in a bag as it does when it comes 'out' for an operation and so I used an idea from a screen I made some years ago. Layered organza was finely stitched in patterns and then cut away between the stitches.Some areas were left complete and some are cut away and very fragile. Betweeen these are more unseen areas  of 'damage'.
  To complete the surface I added scraps of organza as strange little florets because the cut edges catch on all around them, rather like the regrowing fascia can in the gut after an operation.
 The final touch was to put a drawstring around the edge of the bag and sit the 'guts' inside.They then sit atop the 'vascular' layer of the 'body' and have to be carefully extricated every time we demonstrate it.
  The organza has interesting qualities in this its 'organdy' version, that is to say in cotton. Despite its fine weave it holds shape well and can be used for very sculptural work. As it is transparent it allows no faults or hiding of mistakes. It is both strong and very fragile, mostly when cut into smaller pieces where it starts to disintegrate.By layering it you can create what I have been told are perineal spaces within the work!
 The final poetic mysenteric bag is shown here.

Textile Body part two:bypass

 On of the most interesting operations I have watched was the unblocking of an artery which then required a patch. Whilst watching I often begin to compare what is happening to problems I have had when making something and when the blockage was removed I thought of some antique silk pearl string that I had.It was yellowed and tangled and had finally found a purpose!
 I wanted to replicate something of what I had seen of vein harvesting and arterial bypasses for the Textile Body and so my thoughts turned to the delicate stitches and structures which must be handled. 
  I chose cotton organdie which is both sheer and yet robust and used an old technique seen on 1920's afternoon dresses. I inserted rouleaux loops (thin fabric tubes) between two flawless panels of the fabric using a decorative but flexible insertion stitch to attach them. Using a space dyed thread  emphasised the challenges of unpicking such a structure from its surroundings.The colours of the thread change subtly along the work and would be difficult to match if you needed to replace them and the fabric shows every fault and flaw. Part of one of the rouleaux is stuffed with the old silk thread which can be seen above bulging out of the delicate fabric.
 The challenge here is seen in the contrast between the perfect fabric with its delicate embroidery and the problem bulge.How to remove the blockage or even the entire structure is the task,either would require planning and damage control. Which do you do? and how do you prevent damaging the surrounding material.There is a spare rouleaux which could be either used as a replacement or as a bypass to the blockage. The entire piece is woven through the muscle/french knitting layer.
  In fabric you can see the problems of such a procedure without having to have much surgical knowledge and yet the parallels can also be understood medically.

Textile Body part one

One thing kept occurring to me as I watched operations, particularly open surgery, was that the layers of different tissue structures in the body were all strangely familiar. I could see quilting and knitting, fine silk behaviour and embroidery difficulties. To express this I eventually came to the conclusion that I had to make some kind of 'princess and the pea' mattress structure.

  A favourite illustration when I was little was a picture of that multi layered bed.Over time it was reflected in the fabric swatch books that anyone in the fashion or interiors world would be familiar with. Finally the Great Bed of Ware (and its fabric samples that the public can examine) found at the V&A museum decided me on my course of action.

  It would not be anatomically correct but a parallel in material challenges.It would be in colours that I usually work in and not reds and pinks.There would be no cutting, no stitching and hopefully nothing for the squeamish to baulk at. It would be explorative both literally and metaphorically.

  The first layers are about the skin and fat, then muscle and artery.Underneath those are vascular challenges and delicate organ structures. OR quilting,plain knitting, french knitting, rouleaux loops, beading, trapunto quilting,lucet braid, machine embroidery, needlelace, hand embroidery and silk fortune tellers. OR linen, printed cotton, silk, wool, organdie,paper silk, raw silk, clingfilm and elastic bands. I may also include a little corsetry.
 Posts about the individual layers will follow but this one shows the first dissection down into the body.