16 mm, color, 18 f/s, 4 minutes
Performing minimally invasive heart surgery: Operating was created during a painting action with a surgeon. In order to better understand very complex minimally invasive operations on the heart, I invited the Vienna based cardiac surgeon Wilfried Wisser to do a painting workshop together with me.[i] We bought paper, acrylic colors and paint brushes and spent a full day at a studio at the artist-run center OBORO in Montreal (Canada) where I was artist in residence for a month in 2018. Rather calligraphic and abstract drawings of delicate structures in the heart were combined with analog camera operations of the performance. The body’s interior and the workings in the inside of the apparatus were merged. Thus, a hybrid representation unfolded. Magnification, close-ups and isolation of organic tissue were among the addressed issues. The film was one of my earlier attempts to experiment with light, darkness and multiple exposure with the intention to entangle layers of images, hence, confusing temporality and the perception of space. In addition, I would bring human and non-human elements together. How details of plants, water, a duck, black lines of highly magnified parts of the human heart, the act of drawing and painting are represented on the skin of the film, is, of course, dependent on the light situations I was confronted with during filming.
Washing Hands (2018)
16 mm, b/w, 18 f/s, 4 minutes
The hand washing procedures in surgery: Washing Hands was produced together with the art historian and physical theater practitioner Tamar Tembeck and the cardiac surgeon Wilfried Wisser during a movement workshop in one of the studios at the artist-run center OBORO in Montreal in 2018. Hand washing, according to the surgeon, is an important ritual before he enters the operating theater and performs an operation. He mentally prepares and visualizes the proceedings while washing himself. We began the day with a workout. After this Tamar asked Wilfried to show us the basic gestures he does when he washes and disinfects his hands and arms. We studied each single movement sequence and expanded them. In dry training we imagined clear tab water running over our hands, underarms and elbows. We imaginatively reached out for the lever of the soap dispenser and carefully distributed the antibacterial substance on the skin. After this we continued our cleansing performance with disinfectant. Slowly a choreography unfolded, an orchestration of body parts. Far away from the General Hospital / Medical University Vienna (MUV) where Wilfried and I usually collaborate. I attend surgeries with my camera with the intention to observe gestures. Tamar helped us to turn our attention inwards. We explored usually underestimated aspects of surgery by means of physical reenactment.
2,5k video loop, 6 minutes
In our explorations at the artist-run center OBORO, Tamar Tembeck, Wilfried Wisser, and I combined physical theater practices and painting. The idea to replace the knife with a paint brush in order to compare the surgical with artistic interventions, for example, the skin incision with a line drawing or calligraphy, unfolded during my ethnographic fieldwork in the operating theaters at MUV, where I perform arts-based research already for two decades. The performance of surgery is, according to some of the surgeons I collaborate with, a creative act. Each surgeon has a personal style. Wilfried associates the performance of surgery with the Art of Archery, eastern philosophy and particularly with Zen Buddhism. For him healing is tightly connected with the process of creation. He uses the hand washing ritual as meditative vehicle to easier get into a flow, a rather physical condition that can be achieved through visualization, consciously turning one’s attention inwards in order to literally play concrete actions through. This is an effective way to imaginatively simulate complex operations, comparable with reenactment and rehearsal in sport, music, dance, body and theater work. Surgery is a craft that is based on bodily experience and sensitiveness. Haptic feedback is of great importance. The embodiment of knowledge of the characteristic qualities of the organic fabric and its reactions in the organism’s interior requires to gain a feeling for these inner flows and workings. For the video loop Washing Hands, a snapshot of the procedures, Tamar asked Wilfried to demonstrate how he washes and disinfects hands before he enters the operating room by means of painting the movement sequences. This resulted in a rather liquid bimanual dance performance on paper that has left thick black traces of Chinese ink on the white canvas.
Traces of Leonardo (2019)
16 mm, b/w, 18 f/s, 4 minutes
The handiwork of surgeons increasingly changes through the invention of new technologies. I examine these transformations in my currently ongoing collaborative research project Visceral Operations by means of video ethnography and experimental, multiple exposure analog film. Traces of Leonardo was shot during a minimally invasive surgery in urology at Medical University Vienna (MUV). A man needed to get his prostate gland to be removed. These operations are frequently supported by the Da Vinci tele-manipulator, a remote surgery system with which patients can be operated on from a distance. The device was developed for military purposes to be able to treat wounded soldiers who cannot be transported to specialized clinics. For these surgeries laparoscopic techniques are combined with the use of the Da Vinci device. With this tool even particularly tiny structures inside of the body, which are difficult to reach by hand, can be disclosed in a nerve and tissue protecting way. I try to get as close as possible to the physical aspects of the surgical performance. What kind of perception of the viscera is provided by these electronic precision tools? The operator conducts the procedures from a console. In which ways are his (or her) fingers, toes, and the sense organs orchestrated? The machine is prepared by scrub nurses who follow a certain choreography. At the same time a junior surgeon washes and disinfects the patient’s body. The man has already been put in anesthesia. Before the apparatus is connected with the viscera, the area of operation is being staked out. Little skin incisions are made where the 3D-camera, in the size of a hand blender, material components and tiny instruments are introduced into the abdominal cavities. The abdomen is expanded through a high-tech ‘plumbing-kit’, which consists of connective elements like sluices and trocars. Four of the team bring the Da Vinci arms in the right position on the patient’s stomach and link them with the internal hollows. Through the eyepiece of the console the operator literally finds her- or himself navigating inside of the organs of another person. S/he is there.
Stitches in the Heart (2019)
16 mm, b/w, 18 f/s, 4 minutes
Healing knots: Stitches in the Heart is an attempt to explore the sensory and gestural aspects, the handiwork, of an operation on the mitral valve. The making of stitches by hand needs to be relearned in minimally invasive surgery. The experienced cardiac surgeon Wilfried Wisser is an expert in this particular surgical field. He constantly advances the procedures, combines a variety of technologies and tools with each other, among them the use of magnifying glasses, a 3D high-definition endoscopic camera system, an overhead camera, vascular clamps, specific catheters, sluices, trocars and needle holders. He adapts familiar materials, for example, tape measures, from open valve surgery and other surgical interventions. Each of his movements needs to be in close correspondence with what the tissue inside of the body does. The heart of the patient is being shut down by means of the heart-lung-machine during the operation. Real-time 3D image guidance allows the surgeon to operate with optimum precision and accuracy, although the way to the structures inside of the body is quite long from the surgical site and not at all accessible by his fingers. For the film, I particularly focused on the creation of knots in the depths of the heart. The surgeon wears a headlamp and magnifiers. The dexterity of hands is technologically enhanced. The length of the instruments corresponds with the size of the physical structures in the interior. Material components are transported through the channels and cavities by delicate movements. Valve tissue needs to be removed and replaced. Fine threads are pulled through the physical fabric. The loose ends are clamped on a circular frame that is positioned around the field of incision. One is reminded on the strings of an instrument. Tension and release of the surgical suture material should be kept in perfect harmony.
I would like to thank all of my countless collaboration partners, patients, surgeons, anesthetists, scrub nurses, my colleagues in the social sciences and visual arts, and, last but not least, people of the local communities I visited during my travels! Without them, my research and artwork would be impossible. The research project Visceral Operations / Assemblage is funded by the Austrian Science Fund (FWF). Thank you!
[i] The idea to conduct painting actions with surgeons was developed together with the Polish visual artist Artur Zmijewski who invited me to contribute with a symposium in the Internal Medicine Auditorium at the Charité Hospital entitled Anatomy Lessons to the 7th Berlin Biennale for Contemporary Art (June 2012). Lit.: Christina Lammer and Artur Zmijewski (eds.), Anatomy Lessons, Vienna: Löcker Publishing House, 2013.
Operating (2018): https://vimeo.com/299173899
Washing Hands, part 1 (2018): https://vimeo.com/299176151
Washing Hands, part 2 (2018 [digital]): https://vimeo.com/376776543
Traces of Leonardo (2019): https://vimeo.com/372177797
Stitches in the Heart (2019): https://vimeo.com/381168259