No Easy Answers in Bioethics Podcast
‘Imaging and Imagining Illness’: Devan and Darian Stahl - Episode 7
March 8, 2018
The recently released book Imaging and Imagining Illness: Becoming Whole in a Broken Body began as a collaboration between sisters Devan Stahl, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Pediatrics and Human Development, and Darian Goldin Stahl, artist and printmaker. The edited volume examines the impact of medical imaging technologies on patients and our wider culture. In this episode, guests Devan and Darian share the personal origins of their collaboration. They discuss Darian’s artistic process, how audiences have reacted to the artwork, and how they came to invite other scholars to build on their work. By and large, Devan and Darian’s story delves into the intersection of art, illness, disability, and self-identity.
This episode was produced and edited by Liz McDaniel in the Center for Ethics. Music: "While We Walk (2004)" by Antony Raijekov via Free Music Archive, licensed under a Attribution-NonCommercial-ShareAlike License.
Darian Goldin Stahl Photo Credit: © Concordia University/ Lisa Graves.
- Dr. Stahl explores how we see illness in new book ‘Imaging and Imagining Illness’
- Dr. Stahl published in ‘Journal of Medical Humanities’ special issue
- Seeing illness in art and medicine: a patient and printmaker collaboration
- To see more examples of Darian's artwork, please visit her website: dariangoldinstahl.com.
Liz McDaniel: Hello and welcome to another episode of No Easy Answers in Bioethics, the podcast from the Center for Ethics and Humanities in the Life Sciences at the Michigan State University College of Human Medicine. Today’s episode focuses on the intersection of art, illness, disability, and self-identity. The recently released book 'Imaging and Imagining Illness: Becoming Whole in a Broken Body' began as a collaboration between sisters Devan Stahl, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Pediatrics and Human Development, and Darian Goldin Stahl, artist and printmaker. The edited volume examines the impact of medical imaging technologies on patients and our wider culture. In this episode, guests Devan and Darian share the personal origins of their collaboration. They discuss Darian’s artistic process, how audiences have reacted to the artwork, and how they came to invite other scholars to build on their work.
Devan Stahl: Hello my name Devan Stahl and I work here at the Center for Ethics and Humanities in the Life Sciences, as an Assistant Professor of clinical ethics.
Darian Goldin Stahl: And I am Darian Goldin Stahl and I hold an MFA in Printmaking from the University of Alberta in Canada, and I am currently a Humanities PhD student at Concordia University in Montreal.
Devan: So, you might notice that our voices sound similar, and this is because we are sisters.
Darian: Yeah you might have noticed that we have the exact same last name.
Devan: Another great signal that we might be related. So today we’re going to let you know who is talking. I, Devan, will be speaking from the patient experience, and Darian will be speaking as an artist. If you get confused, I say just sit back and take in our melodious voices. [Both laugh] So today we’re gonna talk about a book that Darian and I wrote, called ‘Imaging and Imagining Illness’ that has recently been released from Cascade Books and you can find on Amazon! ‘Imaging and Imagining Illness’ is an edited volume that examines the impact of medical imaging technologies on patients and our wider culture. This book began as a collaborative project between Darian and myself about five years ago. Does that sound right Darian?
Darian: Yeah that sounds right. I knew that I wanted to collaborate with you as the focus of my MFA research in visualizing disease starting in 2012-2013.
Devan: And your MFA is your Master’s of Fine Art, is that right?
Darian: That’s right.
Devan: Okay, about 10 years ago I was diagnosed with Multiple Sclerosis or MS, and my physician diagnosed me in part by looking at some MRIs. Because MS affects the nerve connections in my body, every year or so I get hundreds of images of my brain and spine, so that my doctors can monitor my disease progression. And so now I associate my disease with these particular images. Now if you’ve never had an MRI, they can be, well, a bit of a nightmare. When I get MRIs, technicians strap down my head, they put an IV in my arm, so that they can put dye into my blood stream, and the sessions can last about three hours. Now the tube they put you in is super narrow, and it’s very loud in kind of this arrhythmic way, so there is really no way to fall asleep, and you have to be very careful not to move or they have to start all over again. Needless to say, this is not the most enjoyable experience. And as I described what it was like to have MS and what it was like to get these MRIs and see all these images of my body, Darian and I found that we had this kind of odd scholarly interest that we shared. We were both really interested in Renaissance anatomical textbooks. Might sound like a bit of a non sequitur but we’ll get to how that’s involved in a second. So at the time I was teaching a course at St. Louis University called “Freaks and the Medical Body,” which examines the ways in which medicine has participated in the freak show, and how our understanding of the normal body and the abnormal body has changed over time. I showed my class images from Vesalius’ classic text “de Fabrica,” and compared these images of human bodies to the textbooks we have today and the images we see from medical imagining technologies, such as MRIs.
Darian: And while Devan was teaching this course, a couple states away at this exact same time I was earning my Bachelor’s of Fine Arts in printmaking at Indiana University in Bloomington. And my own interests in, maybe, dubious depictions of the body began when I took a course on the History of Anatomy. I became fascinated by the deeply held misconceptions of our anatomies, like how Galen depicted the human body with a five-lobed liver, or the belief that there was an extra organ at the base of our skull, called the rete mirabile, which were both illustrated in anatomy textbooks well into the Renaissance. These misconceptions of the human body were held for so long, because it was assumed we shared more anatomy in common with other mammals. Whereas barn animals could easily be dissected, and it was extremely rare to dissect humans until the late Renaissance.
As Devan mentioned, Vesalius’ illustrations of anatomy were truly groundbreaking, because he performed human dissections himself and used first-hand observation to correct false anatomical beliefs. He also rendered the body in a completely new and elegant manner. Before the photographic breakthroughs of the late 19th century, anatomists relied on printmakers to illustrate how the body worked. Because, of course, all of these images of anatomy had to be hand-carved into woodblocks, inked up, pressed into paper, and bound into pages in order to disseminated. The evolution of craft and collaborative relationship between anatomists and printmakers is perhaps best evident in Vesalius and Stephan von Kalkar’s anatomy tome, “de Fabrica.” In these images of the body, the cadaver is not lying down, but almost dancing across the Italian countryside. Well, until the figure’s muscles are so dissected that and he has to prop himself up against a pillar in order to keep from crumbling to the ground. I loved how the cadaver felt as if he were still alive and teaching us about his inner body. This union of function and aesthetics was so intriguing to me because of the stark contrast to how we depict the body in medical images today, which are unmoving, generic, anonymous, and completely objectified. Vesalius and Kalkar’s prints made me reconsider the purpose of anatomical images.
Devan: Darian I love how you describe that as the body sort of dancing because I hadn't thought of it quite that way before. If- I encourage people to look at these images, but they're always like in a field or in the city and they're, you know, maybe his hand is raised up, but yeah they're sort of, and they're meant to be pushed together right? So in the textbook maybe they're sort of separated but when you put them all together he's sort of twirling around in these sort of different landscapes.
Darian: Yeah there is, it's called an accordion file, and you can kind of imagine this, just folding of a very long sheet of paper into a zig-zag and you, it fits into the book and you can also pull it out, and that's when you can see all of the figures side-by-side and it is this twirling, the hands are going up into the air, and pointing above and below, and it's a beautiful way to depict the body.
Devan: Yeah and so you compare that to maybe like ‘Gray's Anatomy’ which is you know it's sort of this big move toward you know you just want to see the heart on a page sort of drawn in its simplest terms with kind of the arrows pointing to it which is a very different way of depicting the body than that sort of dancing across the Italian country scape.
Darian: Yeah they were built meant to be educational, but somehow there was this gap between subjectivity and objectivity.
Devan: Yeah, yeah so the pictures in ‘Gray's Anatomy’ are meant to be more objective, and objective means that you can't, you know, be dancing. Apparently dancing is quite subjective. [Both laugh]
Devan: Okay, so, so Darian and I began thinking, what if there was a way to depict the body in ways that were more like how those older artists depict them in textbooks? So, how could we recreate something of what Vesalius was doing? How could a medical image signal more about the human experience than a simple MRI or a scan could allow?
Darian: And this initial idea started my research into the body as a metaphorical vehicle for narrative, and how medical images can include context, movement, and atmosphere that tell us something more about the lived experiences of the patient, like her daily life living with chronic illness. The patient in this case of course being you, Devan. She began writing about her memories of being diagnosed, thinking ahead to an altered future, and the unease she felt with the unpredictability of her body. Then I began to depict these narratives visually.
And I had this breakthrough moment in the process of visualizing disease when Devan mailed me a CD of her MRI scans that she received from her doctor. This cache of medical scans moved all through her head, face, and body, but I couldn’t recognize Devan in a single image. I thought about what was missing in these pixelated, black and white images of anatomy, and I concluded that it was skin. I sought out the scans that perhaps held a clue to her identity, like the curve of the ear, or an impression of the cheek. But the scans sliced right through your face [both laugh] and the images became monstrous and completely unrecognizable. And I then decided to return flesh to these scans, in the hope of rehumanizing their anonymous qualities.
Devan: Was that the first time you ever thought of me as a monster? I am the older sister, so… [both laugh]
Darian: Maybe not, but… yeah it was quite horrifying especially going from maybe the front to the back where it’s going through the nose and all the teeth, and I just, I wanted to see the face and it wasn't there.
Darian: So in order to inflesh these scans again I discovered a way of kind of “scanning” my own skin, and then I would layer them with Devan’s MRI scans through the printmaking process. And after so much trial and error, I found that if I lightly dusted powdered charcoal over very smooth paper, and pressed my body into it, the oils of my skin and the weave of my clothes lifted the charcoal, and left a perfect negative impression of my body in the paper. It was kind of amazing to see the amount of clarity I was able to achieve with this technique. You could see the creases of my lips, the movement of my eye lashes, and even the copious amount hairs on my chin—which I wasn’t really aware of before this moment.
Devan: They’re very fine baby hairs.
Darian: [Laughs] Yeah, it was a bit of a surprise. So, after joining these skin scans with Devan’s MRI scans I was able to create a fully fleshed out figure. And then I placed this new figure in the context of the home. Maybe instead of dancing around the Italian countryside it made more sense for this depiction of Devan to be in the home as maybe the space where she has the time to contemplate living with disease. I depicted this figure at the foot of stairs or looking down narrow hallways imagining how her body might navigate these spaces in the future as her disease progresses. And I see this figure as symbolizing our collaborative process. Our scans have combined to form this new, kind of third figure that exists between us, who represents our goals to give context to the medicalized body.
Devan: Yeah, and you sort of literally press your flesh into those scans, so it's my brain or my spine and your sort of pressed flesh, so we become this one figure in your art.
Darian: Yeah. It wasn’t too difficult to line up, your scans and my body. I think the only thing I really had to do was make my- make the scans shorter. Because you’re very tall. [Laughs]
Devan: I am very tall, I’m a lot taller than my sister Darian. Yeah, so, and just a plug for Darian’s art, you should go check out her website, dariangoldinstahl.com. D-a-r-i-a-n-g-o-l-d-i-n-s-t-a-h-l.com. And she has all of the past exhibits that she’s done and lots of pictures, so you should check them out. It’s hard to convey exactly on a podcast. So folks should check it out.
Darian: Yeah, it is a visual medium.
Devan: It is a visual medium, that’s right. And, I've been to now a couple of exhibits with you where I've been able to sort of stand back and see people as they comment on your art and it seems like people really respond well to it. Would you say that?
Darian: Yes! I would say that the responses have been overwhelmingly positive, though it really does depend on who the audience is in that moment. I’ve found that caretakers have a very emotional response. I have tried to leave the figure that I portray in these prints very open, with little definite features, so that anyone is able to project their own experiences onto this image. And during my master’s program, my advisor began caretaking for her ill father. And when I first showed her this work, she was able to immediately identify with the images being shown. Even though the figure is portrayed as a woman, she felt the concern of moving her father up and down stairs and through the other domestic spaces of her home. You know, caretakers are often isolated and overworked, physically and emotionally. And I felt what I was doing in this moment was building a community in the gallery space that tries to combat this isolation. Another group that has a very different response is physicians. They are fascinated by my use of the scans, I think it's something that they see in their everyday lives completely transformed into a fine art piece, but they still try to read the scans. A member of my thesis committee was a neurologist, and she was concerned that the MRI scans weren’t portrayed clearly enough. It was almost a warning to me that I would receive criticism if my audience couldn’t see the lesions in Devan’s brain scans.
Devan: Which is pretty funny because I don't think anyone but a physician could possibly see that, right?
Darian: Right. And-
Devan: You have to be trained.
Darian: This is a thing that has never happened. Nobody has ever asked me to point out the lesions in the artwork. I use the scans as a greater metaphor for living with the disease, and I think the audience is able to, to feel that, and they’re not searching for the lesions.
Devan: Yeah but the physicians are, I remember at least once when we presented maybe at an academic conference and there's a physician in the audience, when we put up one of these scans they immediately know what my diagnosis is before we say anything about it. They can tell right away.
Darian: Really? I can’t tell at all. I don’t know, I’m not a technician or doctor.
Devan: Right, and you can sort of be trained. I mean enough physicians have helped me to see them, to see those spots, so I can now see them because I've been sort of trained by my physicians to see that. But it's not, it’s certainly not something you'd be able to tell without any kind of training.
Darian: Right. The lesions aren’t so huge, at least to my perspective, that I would see the scan and immediately know something was wrong, quite the opposite. They just look like a beautiful regular brain, Devan.
Devan: Oh, thanks Darian. [Laughter]
Darian: But, there have also been a few times where viewers find the images quite alienating, and maybe too charged and emotional to engage with at all. One gallery goer asked me why I would make art so sad, when art is supposed to make you feel happy. And others have asked me why I don’t include more, maybe, rainbow colors, and still others won’t talk with me at all about the work. I remember one time during my master’s I invited a professor into my studio for a critique, and he basically refused to talk about the work once he saw it. Maybe I hit a nerve with him, and he didn’t want to go there? I really couldn’t say, but I don’t think that this work is overly sad. I think of it as an honest portrayal of a very real possibility of impairment, and it deserves its own contemplative space.
Devan: Yeah, I also don't see your art as sad. I mean, some of the initial art was very black and white, but that's because the MRIs themselves are black and white and so it fit the theme. A lot of your more recent work does have a lot of those brighter colors in it, so that is somewhat of a change but, yeah it's not, it's only sad if you think that impairment itself is something to be sad about, which I don't, and I don't think you do either. So to me it's sort of it's celebrating like this fuller body and a fuller experience. Which is not sad. Which isn't to say it's not never- it, you know it might be sad sometimes, but that's certainly not the emotion that I associate with your art or with my disease.
Darian: Right. I feel the same way, I get why people might feel that way when they're looking at it, but I also think that they're bringing their own emotions to the table.
Devan: Right, art is sort of this reflective experience where people are, they bring as much to it as maybe they, maybe a lot more than you intended.
Darian: Exactly, and that's the beautiful aspect of art is that it has this multiplicity of interpretation, which is perfectly fine. [Laughter] That’s what I want people to come away with is how it fits and relates to their own experiences.
Devan: And what's so great about that, I love that word multiplicity because, kind of the idea initially was that these images have a single interpretation, right? They say something very particular, they say something that the physician is looking for, and you either have it or you don't. Whereas as the artist you're allowing for kind of a multiple interpretations of that image, a kind of multiplicity of all sorts of different subjectivities that can go into that, and that's very different than what it would be used for in the medical setting.
Darian: Yeah, it's a completely different language, but still drawing from the same core set of symbols, and I think that there's room for more subjectivity in the medical side of things it doesn't just have to be this singular purpose image. Maybe for a diagnosis, but to acknowledge that images are powerful and will have more than one effect to anyone that sees them.
Devan: Absolutely. So, Darian and I also began presenting our work together as I said at different medical conferences, at medical humanities conferences and bioethics conferences, and writing papers about this collaboration. And we began thinking, so if my narrative and Darian’s art can come together in this way, might other scholars from other disciplines also have something to offer our project? Darian sees my MRIs differently than my doctors do, and even than I do. So, could a philosopher, or a theologian, or a visual culture theorist also see them differently? And then we thought maybe we can invite these other scholars to read my narrative and Darian’s description of her art, and build on our work. So, in the- ‘Imaging Imagining Illness,’ this book we’re talking about, I begin this volume with a short pathography, which is an illness narrative describing some of my interactions with the medical community, and my initial diagnosis. I explain how I experience the process of MRI scans, interacting with various clinicians, and the influence my illness has on my self-identity.
Darian: In the next chapter, I give my own interpretation of Devan’s illness and bodily images through my fine art prints and artist statements. I add my own remembrance of her diagnosis and how it affected our family and then my artistic direction going forward.
Devan: Then Dr. Therese Jones reflects on my story and Darian’s art through the lens of the medical humanities. Dr. Jones picks up on the themes of liminality, pathography, and identity formation in illness.
Darian: Next Dr. Kirsten Ostherr’s chapter details the history of medical “technovision,” and the ways in which patients can use creative forms of expression to reclaim their body identities. Using the lens of visual culture and media studies, Dr. Ostherr describes how patients can disrupt the biomedicalization of life and empower themselves in the digital age.
Devan: Then the final two chapters reflect on all four of the previous chapters, adding additional layers of meaning and interpretation. Dr. Ellen Armour writes as a theologian interested in biopower and resistance. Dr. Armour’s chapter is concerned with how certain images and narratives can mirror or resist our modern ways of knowing and being in the world. And then Dr. Jeffrey Bishop, a physician and philosopher in bioethics, considers the power ontology of medicine, as well as patient empowerment and the dark gift of bodily frailty. Dr. Bishop emphasizes what’s gained in self-giving.
Darian: And we were also lucky enough to have Rosemarie Garland-Thomson write the foreword, in which she highlights the field of other women who create disability art. And on a personal level I had been studying Rosemarie’s writings for my dissertation, and she had quickly become an essential scholar for my research topics. So I was overjoyed, it was such an honor to have Rosemarie reflect on our collaboration, and to be grouped together with other incredible women working on the topics of disability. I had known these other artists Rosemarie discusses for years, when I was studying for my MFA thesis defense. Riva Lehrer out of Chicago, Laura Ferguson from New York City, and Katherine Sherwood in San Francisco are all my personal art stars. So to be considered in their orbit is a dream.
Devan: And well-deserved, Darian, I would say.
Darian: Thank you!
Devan: So what we end up with, in this volume is sort of a work that builds upon itself. The authors are reading the other authors and building on their ideas, and sometimes challenging them. And I conclude the book with some reflections on the themes that came up, including the power of biomedicine and how patients can resist it or submit to it, how medical imaging affects identity formation, and how patients like myself might be transformed through chronic illness but also through art.
Darian: The arc of the book traverses the MRI scan from idol to icon. At first the MRI confines and limits Devan and becomes the only way her doctor can see her, whereas my art helps to turn the MRI into an image that incorporates Devan’s reality.
Devan: Right, Darian’s art and these other multiple interpretations offered by the contributors turn an image that once felt very intimidating and alienating into an image that reflects more of who I am and may even change the way others see themselves.
Darian: As far as my own artwork, our book has given me a new perspective on the importance of flesh, which has since taken on an even more preeminent role in my printmaking practice. In her medical scans, Devan’s flesh is punctured and set aside. The labor in giving back this flesh that was lost in the pursuit of a diagnosis, is seen as a kind of transubstantiation for our other authors. Skin’s employment in shifting Devan’s scans from an image on a screen to real-life relation with flesh gives shelter, care, and identity to Devan’s internal anatomy. We hope that this process allows others to see their scans differently, and perhaps even inspires them to reclaim and re-present their own scans into a personal vision of identity.
Devan: So we’re very proud of the book, which again you can get from Wipf and Stock Publishers or from Amazon.com, and if you feel like it, and if you like the book you should feel free to add a review!
Darian: Yes, please give us a review, but only if it’s positive. [Laughter] If it’s negative don’t, just ignore that.
Devan: That’s right if you don’t like the book you can just keep that to yourself. [Laughter] Alright thanks Darian.
Darian: Thank you Devan. Thank you everybody else who is listening!
LM: Thank you for joining us today on No Easy Answers in Bioethics. Please visit us online at bioethics.msu.edu, and follow us on Twitter @MSUbioethics. This episode of No Easy Answers in Bioethics was produced and edited by Liz McDaniel.