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Art of medicine


key note lecture WONCA International Congress The Art and Science of General Practice, Vienna 2012


Ladies and Gentlemen,

The first title of my talk was "art and medicine", but I wanted to change it into: art of medicine. I find this more convenient. You will probably understand what I mean during my talk.

I feel excited to speak as an artist in front of you all distinguished Physicians from all over the world. It is a great honour for me, and I hope to deserve it. First of all I like to tell that I have just lived some wonderful weeks, full of new experience, deep insights and strong emotions. The past few weeks represent an important time in my life, and in the life of other people close to me. It was and is a high time for me, an extremely intense time, as I have said, and I wouldn't be exaggerating saying that it was a life changing, ground breaking one.

As you see me, here in front of you, I am quite different from what I was when I had received this invitation to speak to you at the occasion of this congress some months ago. It started exactly one week before Easter, on the first of April, when my eighty-five year old father had a stroke in the late Sunday evening.

I rushed, like all family members, to join him in the hospital on Monday. A unique series of encounters started: encounters with my father, encounters with the other family members, with friends and relatives. When I came to hospital, I found my father in bed sitting upright in deep trance, his tongue and throat paralyzed, and of course unable to speak. He resembled much a mountain, in his silence and serenity, and we were filled with awe when we left him. Though in absence – in the double sense of the word – he then started to direct or guide us in a quite subtle way.

In the following weeks my father returned to life, step by step, speaking, walking, reflecting, eating. He had been brought to a special Clinique and my mother never left his side. I observed how he managed to reconstruct his body from the moment he announced that he wished to live a few more pleasant years. He reserved his capacity to speak for the more substantial use only, while we were trying to solve some old inner conflicts in the family, so that day by day the whole system had changed in an almost unperceivable way, but into quite perceivable results.

People came to me with gloomy faces asking how my father was. I felt repelled because I was still filled with this expanded and deep knowledge, my progress in understanding life. Oh, I said, he is so fine! Never worry! He is doing great.

My father's story inspired me how to conceive a substantial relation between art and medicine. I had intended to talk a little bit about art and art therapy or the therapeutic effects of a certain art, but now, after all this, I like to start by a much more radical approach.

Art and medicine: i.e. art itself as physiotechne or an advanced technique of autoplasticity: Body or performance artists affirm repeatedly that the body is the first material of art. As I have learned from my father's unique career as a stroke patient that this was true: indeed, the body itself forms the first material of art. The body is sincere and apt to perform the symptoms, all symptoms, in immediate expressions. I refer to the notion of the "symptom" literally, as it is composed by "sym" and "piptein" or "ptoma", which signifies the case, the chance, the hazard. The symptom is the appearance of what is coming together in a hazard. The composition of what comes together is the body, which is in itself a self-arranging arrangement, an autopoetic poetry, a cybernetic artwork. The body might be considered as an expressionist artist, but sometimes it is conceptual, sometimes suprematist, and often very abstract, too. The expressions or modifications my father's body had invented or created were strong and even violent. Now I understand what Joseph Beuys – by the way, the same generation as my father - had tried to express with his formula "everybody is an artist". The everybody's art of course tends to be of the more direct and activist type, even if silent or mute, if apathic, hypnotic, catatonic, even if in anaesthesia. The body in itself forms a complex relational system of interconnected meanings and functions, it is a superb installation piece, so to say.  The autonomy and dignity of the body-artist or the body-as-artist is infinite, a well driven, well set-up device of showing, manifesting, visualizing. But it is also a social intervention art piece as it manages the exchange with all the other body-artists colleagues, too.. This complex installation piece is then interacting with other pieces of the same kind in this expanded gallery called "the world".

As an artist concerned with the body I am not only a performer, a performative artist, a body-based artist or a sculptor but also a bit of a medicine man or woman. How? Why? Oh no, you may think. The "primitive" or direct way I established the living body as an author of symptoms or art pieces, so to say, makes me myself a "primitive" doctor. I am treating the bodies: my own, the trees' and the audience's bodies. My primitiveness is an advantage for me: I escape from the criteria of professionalism in medicine, but am fully souvereign in the art of symptoms. As far as western medicine is in high specialized levels an esoteric system, too, that will not allow non-experts to peep behind the curtain, it has tended to become an alienating machine. This is not medicine for everybody, and cannot be. Art tries at least to be definitely just the contrary. Doing art means doing non-alienated work, legitimated by one's own rights, fully autonomous, following one's own rules and intentions, using the material available, suitable and in evidence. To introduce a little bit of the art's character and quality into the field of medicine would make it not only more colourful, playful, or comfortable, but also repair the problem of the patient's inevitably reduced autonomy. An art-medicine man or woman is a good thing to be because he or she suggests alternative narratives of health and disease. The medicine man or woman may translate the technical discourse into a tale that can be understood, i.e. be affirmed by the body-artist saying: oh yes, alright, this is perfectly my story. This gives the symptom-producer at the core of the constellation access to the diagnostic meanings to be shared with him in a common world. It does not reduce medical complexity, but translates it for the sake of the patient's subjectivity. Art-Medicine man or woman comprises therefore an artistic-medical concept, bringing together the best of these two fields.

How? Art in combination with medicine protects – in this complexity – the dignity of the symptom producer or artist.  If we look at this hybrid, the symptom producer as an artist,  from the art angle, the medicine man or woman is the one who gives a lot of importance to that production. In art, this person giving importance and value to the art piece is called the curator. The curator curates or maybe cures the art or the symptom-producer as an art piece of its very own. By the notion of the curator, it is easy to see how similar the two fields of art and medicine are organized. Both of the fields are organized in pairs: the art of symptom producer on one hand, and the curator on the other. In art, the act of curating or the curator requires a museum or a gallery, in medicine the act of curing requires a medical office, a doctor's surgery or a hospital. We have a big debate on the relation between the artist and the curator in the art field. There are extremely powerful curators like Obrist etc., and I guess there must be very powerful and mighty doctors, too? The question in art is: who is the more important one? Who is best in producing and who is best in reading the symptoms? Who is best in the very challenging General Practice of deciphering the symptoms, reading the art? I propose to put the curator on the same level with the artist. Because the artist and the curator establish a couple and cooperate in the production and reading of symptoms. Together they establish what is called "art". This couple may also be found in the realm of the living bodies: the medical curators cooperate with the bodies whose willingness to cooperate they fully depend on. Together the doctor and his or her patient act out the art of healing in a very very specific and essential way.

The art of healing and the fine arts have a lot in common. The structures of medicine and art even increasingly resemble each other. First reason:  there is a strong emphasis in contemporary art on the body and its capacities. This makes contemporary art somehow medical, gives it a medical touch, so to say. Second reason:  there is this basic cooperation of the symptom-producer and the curator. Third reason: the spaces of medicine and art are aesthetically similar, as far as they happen or occur in white spaces. Very white. There are no spaces as white in the whole world than the medical and the art space. The symptom producing bodies go to the cabinet or to hospital, while the art is presented in galleries and museums. All white spaces. The white spaces symbolize the body in crisis calling for the curator. But it symbolizes also "science". In both cases specialists come and take care and curate. Furthermore, exhibiting and curating the symptoms, both in medicine and art, constitute a huge market.

Even the objections against the art market and health market are of the same type: there is a certain discomfort about the fact that art, respectively the living body, are short-circuited with the monetary system in a direct capitalistic way.

Nevertheless, I would conclude my little talk, the art factor guarantees a constant re-evaluation of that fact. The artist will not stop questioning the art-market relation, and so will hopefully the symptom-producer as an artist scrutinize the health system. Maybe one important condition will be the transformation of the patient into an artist of his or her own rights who will not only be granted these rights by his or her curator or doctor but fully recognize his or her authorship regarding the symptoms in the sense of an affirmation like: yes, this is me, I did it, I sign for it, its my art piece, my life piece.


© Copyright: Elisabeth von Samsonow, 2012.