Amy Goh: Swimming in darkness

Amy Goh’s first illustration is for this story:

Some friends and I had driven north from Auckland one night. We missed the turn-off to our destination and by the time we realised we decided to continue north, as far as we could go. We took a back road and drove through a herd of wild horses, running through the headlights. We hit the dunes and the car was stuck in the sand. I went for a walk by myself. There is quicksand in places. The sky was blanketed in cloud so neither the stars nor the moon were visible. The land is low here. I walked for what seemed like hours; the beach stretches on forever. I then had the reckless idea of going for a swim. I stripped off and swam out through the breakers. It was summer and the sea was warm, so I kept swimming. I then recalled the stories about this beach, there are rips and holes and currents that can carry you away. I was far from shore and disoriented, too far to hear the sound of the surf, or to see the dunes. Just a human body swimming in darkness far out to sea. I prayed and chose a direction and eventually found the shore. I kissed the sand and collapsed. It took hours to find my clothes and I somehow found the car, and my friends, one of whom had not left the car all evening for the fear of horses. Words can sometimes be prisons for meaning and if I were to try and explain I could not capture this experience in its true context. All I know is that blind chance and dry logic will never capture the mystery of this life. Gratitude is easy when you know how.

Hamish, Ninety-Mile Beach, Aotearoa/New Zealand, 1999.

You can find out more about Amy Goh’s work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

For our Day of the Dead event last year, we commissioned a short documentary exploring the tradition of  ‘Dia de los Muertos’. Filmmaker Betty Martins reflects on the relationship between truth, memory and representation.

What I find very interesting in making films such as this one is the relationships that are initiated during the production process. The research, meeting the participants, the interviews and the editing is all about working on those relationships and that network-specific knowledge that we gain from this process, which is reflected in the direction that the work takes on until its final production.

This project is the exercise and the documentation of people’s personal memories, and we shot over one hour of footage for each interview. When watching the unedited video again and again you feel like you’ve been immersed into their memories. And while you are imagining their past through their remembrances, trying to make sense of a narrative while editing carefully each piece, you are also kind of re-assembling those memories. You then develop a relationship of affection. And that’s how the final work becomes a result of the work of those relationships. It is naive to think a documentary is 100% honest to the actual facts, especially if your work is based on people’s memories. If you consider that even one’s individual memory is already a reconstruction of the actual facts, we can understand that the narratives and its representations are relational. That’s what happens with projects such as this one, and it is in these complexities that, from my point of view, there is an artistic value.

Betty Martins is a filmmaker and educator. Find out more about her work at www.d-aep.org.

Polly Alizarin Harvey: darkness into light

Polly Alizarin Harvey’s latest illustration is for this story:

I had 17 years of unnaturally bad luck after doing Ouija boards when I was in my teens. I thought at the time they were just fun, but realised as time went on that they had opened a door in the spiritual realm that was quite real, and horrible. I visited a church where the curate announced God had told him that there was someone here who’d had a lot of problems with Ouija boards they’d done years ago! I was amazed. I decided I couldn’t take any more disaster and cried out, asking God to help me. I said I would take Jesus as my saviour and become a Christian. I received prayer to cut me off from my past involvement and later, while alone, heard a voice that said to me, “it is Finished”. I knew it was God and prayed all day for Him to explain! The next day by pure ‘coincidence’ I read that Jesus had said those words on the cross to declare that his death had defeated all evil. In fact they are considered by some to be the most famous words in the Bible. Since then (about ten years now) my life had been full of blessings! It has been amazing!

C Ashenden, London, 2003. For Jesus, for turning darkness into light.

You can find out more about Polly Alizarin Harvey’s work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

Becki Hiscocks: Love conquers all

Becki Hiscocks’ latest illustration is for this story:

I would like to thank the miracle of love that has joined my life and turned my life into a paradise, after 25 years suffering of depression. I would like to thank my cure and the healthy mind I have nowadays, in spite of the doctor’s diagnosis, which told me I would never heal my self-esteem issue and I would take antidepressants forever. I am really grateful now and I testify miracles happening everyday and it is all about love. One’s mind is the most important thing in the existence, therefore I am really glad I can think clearly now and be able to help others.

Renata, Brazil, November. For the Sun of the Universe.

You can find out more about Becki Hiscocks’ work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

A map of London: showing sites of medical and other interest, 1913. Wellcome Images.

Even a short walk through Bloomsbury is an encounter with many ghosts of medical history. William Birnie accompanied Wellcome Trust Engagement Fellow Dr Richard Barnett on one of his recent excursions.

A crisp, sunny December morning was an ideal opportunity to set off on a guided walk around Bloomsbury, to discover the stories of the prominent inhabitants that have lived there over the centuries. We wrapped up warm, met our guide Richard Barnett by the information point in Wellcome Collection, then set off on our Dead Famous (a superbly appropriate title) walk around the area.

A number of characters and their stories made me pause and reflect. It is these I have written about, as to tell every story would require many a book!

During the introduction to the tour, I could not help but think about the sheer number of distinguished and eminent individuals who have resided here. Perhaps the same can be said for many a locale in London, but Bloomsbury does have a distinctive hold on the imagination. The names discussed and evoked bounced around like a succinct cultural who’s who, with Thomas Wakley, William Burroughs, Hans Sloane, Virginia Woolf, and Kenneth Williams among them.

Our first stop was outside a little shop called ‘What the Dickens’. The flat above previously occupied by none other than W. B. Yeats. Just around the corner from this flat there is a house where the poet John Berryman once lived. Berryman is not perhaps as famous as some of his fellow American confessional poets, including Allen Ginsberg and Sylvia Plath, but he was a poet greatly influenced by Yates. Berryman went as far as stating that he ‘didn’t want to be like Yates; I wanted to be Yates.’ This is just one example of the many captivating connections we discovered during our walk.

The crescent facing Cartwright Gardens was laid out in the 1820s, and it was here that Edwin Chadwick, the social reformer, lived for a time. For someone said to be an austere man with no sense of humour, Chadwick had a far-seeing vision when it came to the conditions of the poor. By the 1830s London was the first industrial capital; it was rich and incredibly filthy. Chadwick was part of the Royal Commission established in 1832 to decide reforms to the Poor Law system in England and Wales. Their recommendations were later enacted in the Poor Law Amendment Act of 1834. This New Poor Law aimed for a standard system of relief focusing on the workhouse, as there was a growing view around this time that with the free market the poor were responsible for helping themselves. If they did not, then they were deemed lazy.

Chadwick was appalled at the numbers of people entering the workhouses and felt that if people were healthier there would be a drop in the numbers. Perceiving that dirty vapours were poisoning the population, thus breeding poverty and disease, and extremely  concerned with the question of sanitation, his 1842 report, The Sanitary Condition of the Labouring Population, was published at his own expense. It was a milestone in the history of public sanitary reform.

Next stop: Hotel Russell. The dining room here was designed by Charles Fitzroy Doll, and is said to be almost identical to the one he later designed for RMS Titanic. Irish playwright George Bernard Shaw used to stay here when in London, and we were told a number of his ideas concerning life. Opposed to vaccination against smallpox he felt all modern medicine to be quackery. As a staunch vegetarian he commented: ‘I was a cannibal for 25 years. For the rest I have been a vegetarian.’ He was, however, a great believer in the treatment provided by Dr Jaegar’s Sanitary Woollen System, a system developed in the late 19^th century.

Gustav Jaeger’s book, published in 1880, detailed his belief that clothing made from plant fibres such as cotton and linen were unhealthy. The book promoted the idea of wearing only wool next to the skin. The notion was that sweat, as the body’s way of releasing poison, was bad for your health and by wearing tight clothing made of such plant fibres you were only reabsorbing your own poison. Jaeger advocated the use of wool fibres throughout the home for everyone, and a craze of wearing wool-jersey-long-johns was one taken up eagerly by Shaw. We all had a smug giggle at the thought of George Bernard Shaw strolling out of the Hotel Russell on a hot summer’s day wearing a woollen jacket and long-johns.

A short walk away is Queen’s Square where the writer Frances Burney lived in the late 18^th century. Her first novel, Evelina, was a witty social comedy published anonymously in 1778 and details English upper middle class life from the perspective of a seventeen-year-old woman. Jane Austen spoke of Burney in her letters as one of her favourite writers. She married a French exile and moved to Paris after the French Revolution, and it is during her life in France that her story holds particular medical interest for us at Wellcome Collection.

In 1811, Burney noticed a pain and swelling in her right breast which, after having consulted all the best doctors, was believed to be cancer. An operation was needed: Burney underwent a mastectomy in the days before anaesthetic, with a wine cordial the only comfort given to her.

She recalled the operation in a letter to her sister some months after the event, with the envelope marked: ‘Account from Paris of a terrible Operation – 1812’. Fiction, medical history and suspense combined with surgical data all merge in this letter.  She speaks of being powerless, her body handed over to the surgeons as an ‘objectified entity’. This letter is an important document in the history of surgical technique and also a piece of powerful literature. She writes of waiting for the doctors to arrive, with the ‘seven men in black’ entering her room at three. As she was awake throughout the entire ordeal she is able to remember with remarkable clarity the operation. Gory to say the least, it is in her own words that we can best imagine the horror of such a procedure: ‘a scream that lasted … during the whole time of the incision-& I almost marvel that it rings not in my ears still! So excruciating was the agony.’ A medical report at the bottom of her account tells us that the operation lasted 3 hours and forty-five minutes, and that the patient showed ‘un grand courage’.

In a walk that took us past The National Hospital for Neurology and Neurosurgery, to the entrance of the British Museum and later to the edge of Tottenham Court Road, we covered a lot of distance; characters and time bound together by this one location. One of the last peculiar stories told involved the University of London’s Senate House building, described by Evelyn Waugh as ‘that vast bulk… insulting the autumnal sky’. Seemingly it inspired George Orwell, who would often walk past it on his way to the BBC, to disguise it as the Ministry of Truth in his novel Nineteen Eight-Four. It seemed an appropriate ending for our enlightening tour of Bloomsbury.

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk. If you’ve taken photos on any of our walks, or of other medical sites in London, we’d love you to add them to our Medical London Flickr pool.

Liz Anelli: Never give up on life

Liz Anelli’s first illustration is for this story:

The idea of having children did not come to Patti and me at the same time. But when it did there was new light and new feeling to being alive. Later Patti had four miscarriages, each one of which burned its own new kind of pain into the days and years that followed. Some medical people in the hospital discovered why this was happening and paid no attention to Patti’s age; they went ahead and fixed it so she could have another chance. Guy was born. I would like to give thanks to those people who never gave up, just for the sake of never giving up, and helped us never give up on life either.

Tim Mathews, Cambridge, May 1995. For the gynaecology and obstetrics staff at Addenbrooke’s Hospital.

You can find out more about Liz Anelli’s work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

Mercedes Leon: Apple tree

Mercedes Leon’s first illustration is for this story:

In the front garden of my old grandmother’s house, there was (and still is) a large apple tree. When I was very young, my eldest brother Tom would climb it (against my grandfather’s wishes) and I have a vivid memory, of one afternoon one summer, when my grandfather caught him shaking apples off the branches, which fell and bruised on the lawn below. I was probably only five at the time, but it sticks with me. He got a thrashing for it but he didn’t care! A few years later, my brother began to slowly develop severe depression, which ended in a diagnosis of schizophrenia. For many, many years he became more and more reclusive, and would avoid talking and socialising; the illness and effect of medications severely hampered his desire or ability to do most things. He closed down in many ways and it affected all of the family in a big way. Recently my grandmother (who always managed to stay close to my brother and show him great affection) passed away. In some strange way, this woke up my brother and when my parents decided to move in to my grandmother’s old house, my brother started to help in the garden. I visited a week ago and my mother and father asked me to help them pick apples from the very same tree that my brother had climbed. My brother (who would rarely venture outside his room and often sat in the dark alone) also came out to the tree. As I picked apples high up a ladder I dropped them down to him and he caught them. We spent a whole afternoon doing it and it was and has been one of the happiest afternoons of my life. “Don’t pick the unripe ones,” my brother hollered up at me. It was a crisp, sunny day and he caught every apple I dropped down, gently placing them in the basket. Each and every apple I picked and passed to him, via the force of gravity, felt and feels like a small miracle bringing us, after so many years, closer together again.

J Harvey, Ash Green, Hampshire, 1980-2011. For my grandmother, for planting the tree.

You can find out more about Mercedes Leon’s work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

Double focus X-ray tube. Science Museum / Wellcome Images.

When Wilhelm Röntgen made the first x-ray image of his wife’s hand, the world was astounded. William Birnie looks at a seemingly magical tool of medical vision whose dangers were not immediately apparent.

With the discovery of the x-ray, physicians were allowed their first non-invasive look inside the human body and, unsurprisingly, X-rays quickly proved to be extremely useful, as both a diagnostic and therapeutic tool.

In November 1895 the first X-ray was taken by Wilhelm Röntgen (1845-1923), in Würzburg, Germany, and it was of his wife’s hand. He called them X-rays ‘for the sake of brevity’. The discovery was a culmination of more than a century’s research on electrical discharges in evacuated vessels. There’s no doubt X-rays had been generated many times before their discovery as, in the 1880s, experiments with the cathode ray tubes of Sir William Crookes were very popular. Moreover, Crookes himself had been baffled as to why the photographic plates he stored near his cathode ray tubes kept repeatedly fogging up.

Röntgen used such tubes, covered in black paper, to study the fluorescence produced when cathode rays struck the glass wall of the tube. During one such experiment he noticed that when the discharge was passed through the tube, some crystals of barium platinocyanide spread on a piece of card nearby glowed luminously. In tracing the origin of the light back to the tube a great discovery was made.

Medical X-rays are produced by letting a stream of fast electrons come to a sudden stop at a metal plate. This double focus X-ray tube works by using an alternation current which accelerates electrons towards an aluminium plate, thus producing an X-ray at both ends of the tube. The rays are capable of penetrating some thickness of matter and the X-ray image is created due to different tissue absorption rates: calcium in bones absorbs X-rays most, therefore the bones look white, whereas fat and other tissues absorb less and look grey. Lungs look black on an X-ray image, as air absorbs the least.

Early test objects included the hands of physicians and technicians (with serious consequences later), and model skeleton hands with forearms, made from a frame with silver paper added to simulate the tissues and bones. Small animals such as frogs and snakes were also used.

Scientists all over the world today are closely involved with X-rays. This connection dates back to shortly after Röntgen’s discovery, which was exploited rapidly even 100 years ago. By May 1896 the first X-ray journal, Archives of Clinical Skiagraphy, was published in Great Britain (skiagram was the term used in 1896 for what we would now call a radiogram). In the same month the technique was first used on the battlefield during the Italian-Ethiopian campaign, with physicians able to locate bullets inside wounded soldiers.

The public’s imagination was understandably captured by the suggestion and potential of X-rays. It was incredible that these rays could photograph inside the body and find bullets in soldiers. Public reaction in 1896 was widespread and immediate with the headlines mostly positive: ‘Electrical Photography Through Solid Body’ (Electrical Engineer, New York) and ‘Searchlight of Photography’ (The Lancet). Not all headlines were quite so favourable concerning the new technology, with the London Pall Mall Gazette stating, ‘we are sick of the Röntgen rays… you can see other people’s bones with the naked eye, and also see through eight inches of solid wood. On the revolting indecency of this there is no need to dwell.’

The use of X-rays was one soaked up readily by those members of the public who attended new X-ray lectures. A small fee would be charged to those audience members who wished, and volunteered, to have their hands and purses X-rayed.

Radiography is the first and foremost use of X-rays. It is an extremely familiar one with a variety of applications. For instance, in addition to being used in medicine, the X-ray has been used to detect structural flaws in materials, by chocolate manufacturers to ensure the absence of any metallic particles, to detect pearls in oysters, for security checks on luggage, and to examine Egyptian mummies, plant specimens, and old oil paintings. More familiarly, in the 1920s a veterinary school had a piece of specially designed apparatus installed in order to aid their investigations of bone diseases in army horses.

The dangers of using X-rays were not fully understood initially, with the hands of physicians and technicians used as early test objects leading to dreadful results, from dermatitis to skin cancer from radiation ulcers. Yet there were early indications. In 1896, the Röntgen Society of London formed a committee on X-ray injuries, with a similar initiative following in America several years later. The biological effects were also noted by Thomas Edison and Dr. W. J. Morton, who both suffered from sore eyes after working with X-ray tubes for a number of hours. Although lead protective clothing was worn by some in 1910, it was not until 1921 that a national committee in Britain endorsed protection recommendations.

There was also another reason why safety was seen as being of utmost importance. The use of X-rays was no longer only in the hands of doctors and experts. The commercial applications were extremely wide and it made its appearance in factories and shops. An example of war-time application included the examination of foreign ammunition of unknown construction. This had been hazardous to say the least before the development of metal radiographs.

If Röntgen’s semi-accidental discovery had not taken place, modern medicine would have been deprived in an unimaginable way. A book entitled X-Rays, Past and Present, which was published in 1927 and aimed to give the general reader a history of X-rays, makes an interesting point in its closing pages by stating: ‘not the least important result of the development of X-rays has been that they have formed a common link between other branches of science that hitherto had drifted into something approaching independent existences.’ X-rays, with the subsequent examination into their effect on physiological tissue, allowed the concept of our bodies being nothing but special differentiations of electrical charges to become much more tangible and appreciated than it had ever been before.

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.

Melanie Winning: The human war

Melanie Winning’s latest illustration is for this story submitted at Wellcome Collection:

I was working as a human rights observer and had been asked to remain in the village of Sieda, in the north of the West bank near Tulkarem. Two wanted men were captured by the Israeli Army, and the villagers asked me to negotiate with the soldiers to make sure the men were not shot or injured before being taken to trial. I walked over the hill several times to speak with the soldiers asking to check on the condition of the arrested men. The third time I went to check with the guards, in the house next to where the arrested men were being questioned, I noticed six children aged from about three to eleven years, each with a different soldier holding a gun to that child’s head. While the adults of the house desperately rushed around bringing the soldiers photographs and documents, I pulled out my camera to film this horrific scenario; not noticing an Israeli sniper in the bushes. The sniper then trained his green laser on me moving the laser slowly up and down between my stomach and my heart. I shouted to him that I was not armed, while still trying to film the six children being held at gun point. I walked backwards attempting to get out of the range of the gun and up some stairs. A man allowed me to take shelter in his house, where I continued to try and film the children through the bullet holes shot into the walls of the house. However, the sniper’s gun may have had some heat seeking sensor and he remained able to track me as I moved inside the house. I went outside so if the soldier did shoot me he could not claim it was an accident. I was shaking so much it was hard to film. The Israeli border police arrived and the laser was taken off me and the soldiers took their guns away from the children’s heads. I am grateful that no one was killed, not the six children or my self and I wish to thank who or whatever kept myself and the children safe that day.

Pennie Quinton, Sieda village near Tulkarem in the West Bank, Palestine. For the people of Sieda village near Tulkarem for sheltering me while I was held at gun point.

You can find out more about Melanie Winning’s work and explore more votive illustrations on the Wellcome Collection website.

Could your gratitude inspire a votive? Tell us your story, and it could form the basis for an illustration.

Appliances from 'Mechanical Substitute for The Arms'. Wellcome Images

The development of weapons of war and the development of treatments for those damaged by them often go hand in hand. William Birnie looks at some curious appliances designed to improve the lives of those who lost limbs in the First World War.

It is easier to destroy than to repair, with the resources for destruction provided by society often greater, yet the years during and following the First War World saw significant and exceptional attempts to help those who had returned home permanently injured by destruction on an industrial scale.

Horrific wounds from new technological advances such as machine guns, shell fragments and poison gas meant that over 41,000 men lost at least one limb as a result of their injuries gained during the war (and this was in the British Armed Forces alone). The modern mechanised nature of warfare led one man to write home and comment on the carnage: ‘this is not war; it is the ending of the world’.

The conditions on the front line meant a lower standard of medical care, unhygienic equipment, lack of water, inadequate lighting and poor supplies of operating instruments, including ligatures, needles and supports. When this is considered against the remarkable fact that it took, on average, between eight and twelve hours to evacuate a wounded soldier from the front to a Casualty Clearing Station (CCS), it is not surprising that so many men returned home without a limb. The even starker situation at Gallipoli, where a soldier had to face a voyage of two to three days, led Major Stanley Argyle to despair at the number of limbs that were amputated and lives lost that would otherwise have been saved.

Motorised transport made it possible to establish the clearing stations on the Western Front, which were staffed by surgeons, nurses and anaesthetists, yet these were far from satisfactory themselves and the sheer length of the front often meant they were six to nine miles behind. Trying to operate on filthy war wounds instead of clean unbroken flesh meant the neat techniques in which an ‘aesthetic result’ was paramount had to be abandoned in favour of ‘crude unfinished ways’, much to the chagrin of surgeons working amidst the bloodshed.

Servicemen were entitled to free artificial limbs (until 1948 artificial limbs were provided free of charge only to those who had lost limbs as a result of war service), but by 1915 the existing system could not keep pace. Throughout the war, limb provision remained a problem, combined with a lack of hospital space for men awaiting limbs.

Two American firms, Rowley and Hanger, were invited by the government to set up subsidiaries in Roehampton, London, in the grounds of a former mansion commandeered by the Imperial War Office. This site became Queen Mary’s Hospital and opened its doors to its first 25 patients in 1915. During the war it became known as one of the world’s leading limb fitting and amputee rehabilitation centres, providing treatment and training opportunities so that patients could later find employment. Demand was high and often men left hospital with artificial arms without the proper training in their use. Artificial limbs were made on-site, yet, despite this, limb provision remained a struggle and it was only after the armistice that the situation was brought under control. New mechanisms were patented and lucrative government contracts enabled new research and developments to take place.

The appliances shown above, part of our ‘Treating Yourself’ section in our Medicine Man gallery, fitted to a mechanical substitute for the arms made for an amputee who had lost both arms at the shoulders (a rare injury even during the First World War). They are components of a much larger prototype developed by an Edinburgh gas fitter, George Thompson. The tools clipped onto the mechanical arm, which was then fastened onto a table. The tools and arm would be operated using foot pedals situated under the table and driven by a series of levers.

The idea of this amateur invention was to enable amputees, with practice, to eventually be able to accomplish everyday tasks independently. There is a conventional set of a knife, a fork and a spoon that has been slightly modified, along with weighted scissors, a round metal object designed to carry a cup, a ‘rubber thumb’ to turn the pages of a book, a cigarette lighter, and a fountain pen, the nib of which has been specially angled in order to fit into the ceramic ink bottle.

Moreover, there was a need to provide help not only for the physical, visible injuries connected with the loss of a limb, but also the invisible, mental ones, and a story of consummate resourcefulness can be found in the years after the war in Germany. Physically disabled from birth, Carl Hermann Unthan (1848–1929), helped the physically disabled soldiers when they returned home to Germany by publishing Ohne Arme durchs leben (Surviving Life Without Arms, 1916), an illustrated handbook for disabled veterans. He worked quickly, writing seventy-eight pages of it in twenty days. It was a step-by-step guide how to master life’s challenges and adapt. It seems incredible to believe but Unthan had trained himself to fasten a necktie, use a knife and fork, even play the violin, using only his feet. He travelled around Germany hoping to be a motivator and lead by example.

It is an interesting idea to think that medical treatment is constantly refined to keep pace with the improvements in weapon technology and the damage it inflicts, with doctors and surgeons forced to rethink their interventions in order to give patients the best possible chances of survival. The First World War was the last war where amputations, on otherwise healthy young men, were at such a high level, and consequently provisions had to be made at home for those returning injured.

William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at w.birnie@wellcome.ac.uk.