Chest 132; Discovery

21 Jan
Chest 132 J

Chest 132; Discovery

Discovery consists of looking at the same thing as everyone else and thinking something different.”
― Albert Szent-Györgyi

As a recent challenge the word Discovery was given to me and I have spent quite some time pondering how to describe this in pictorial terms. For me discovery can be as prosaic as getting into a boat and discovering an island not previously known about. But ‘ideally’ scientific discovery comes about through the scientific method – instructions whereby an investigator may lead from a point of ignorance to a position of knowledge. In order to do this, a proposition – a hypothesis – is made, and that is then justified. There is a clear logic that tests whether the hypothesis works or not, but – and this is the important point – there are no rules to guide someone to formulate a correct hypothesis; one that is either plausible, or fruitful.

It is helpful to look at scientific discoveries made by lucky accident or imaginative leaps. An example of the first is that Sildenafil citrate, otherwise known as Viagra, was first developed as a drug for hypertension and angina pectoris for which it was found to be pretty ineffective. However by lucky accident it was discovered to have another physiological effect which we all know about. On the other hand, August Kekulé studying the chemistry of Benzene in 1855 was stuck trying to work out the structure of the molecule. It is alleged; he was half asleep in front of a fire gazing into the hot coals when the flames formed themselves into a snake eating its own tail (Ouroboros) and it came to him that the molecules of carbon in Benzene formed a ring – an example of an inspirational discovery.

So although there is claimed to be an orthodox logic in scientific discovery, discoveries are entangled with irrational thought. There’s been interesting research to show that trying to generate a hypothesis from evidence alone can be unproductive. A good hypothesis often introduces variables that do not figure in available data.

My image illustrates the birth of an idea, Our of the complex darkness, comes a moment of enlightenment. The discovery of a hypothesis from the coming-together of thought, cogitation. A discovery flung out sideways.





Chest 130; Flames

22 Dec
Chest 130 J

Chest 130 Flames

I have been doing a challenge to produce a picture based on my recollection of December. It’s timely of course being close to Christmas and that has influenced the picture produced here. The index X-ray came from a man, originally African, with pneumocystis pneumonia, almost certainly based on immune deficiency – HIV – a disease that in retrospect we were seeing during medical training in Central Africa during the late 1960 and 1970s although it had not been recognised as a different disease, or even named, at that time.

The X-ray was paired with a photo of a wild flower that grew in the bush around our area – Gloriosa superba – what we had known as the Flame Lily. During the hot wet month of December when the long-grass grew higher than our heads, and the bush was hot, damp, and full of colour; huge edible mushrooms and insects of every hue. As children we would make forays into the wild areas collecting flame lilies to decorate our home before Christmas, or take bunches to the old people.

This image shows flames bursting from a chest X-ray, paradoxically signifying the beauty of Africa, but also the destructive nature of the epidemic that swept the continent and still spreads today.



Chest 129; Domestic Violence – how I made this picture.

17 Dec
Fig 11

Chest 129; Domestic Violence

I have been asked to produce a series showing how I make my pictures. I do this in Photoshop. My guiding precepts are firstly to use widely diverse images, and in Photoshop to treat every layer in a different way.

I first search through a museum of de-identified X-rays. Some of these are on line, others are stored either in the hospital or university. Some are in private collections. I choose something that interests me on that day. There is currently a lot of publicity in Australia about domestic abuse and I chose the Chest X-ray of a woman that had been stabbed in the abdomen by her partner. It shows gas in the abdominal cavity. Because she is erect the gas has floated upwards and accumulated under her diaphragm. I decided to make Floating the subject – the “story” of this image.

Fig 1

Although there is often a clinical history with the X-rays they are usually not labelled as to their source I have recently seen victims of domestic violence locally and thought to use local photographs as my linkage for colour offsets. I parked my car at a local beauty spot overlooking the town yesterday morning and took a shot of the valley and hills near our home.

Fig 2

As I was getting back into my car I noticed a discarded piece of rusty metal by the side of the road with old wire loops, and gravel which made an interesting pattern.

Fig 3

In the evening as the sun was going down a shot of the sunset behind our home.

Fig 4

Layered the two scenes in Photoshop and used a blending filter (my favourite is DIFFERENCE)

Fig 5

Layered the rusty metal on top and used DIFFERENCE again.

Fig 6

Inserted the X-ray between the layers under the rusty metal using DIFFERENCE.  Didn’t like the result, the colours were disagreeable, so discarded the morning scene. The resulting clarity and the way the loops of rusty wire and straight edges of the metal contrasted with the branches of the tree silhouette was quite attractive.

Fig 7

The picture still had no focus and no story, so using the SELECTION tool set at about 25% I lifted a section of the X-ray to get interesting shapes and fragments, and the BRUSH tool to colour it with greens and yellows. This is shown below with a red background for contrast. I later reversed the shading to make light coming from the left. I then used the EFFECTS tool to give the contours BEVEL, applied a DROP SHADOW, and co-ordinated the shadow direction with shadows of the background stones and loops.

Fig 8

The shapes looked a bit like seaweed or algae to me. Layered on top of the picture the shadows make it look as though the seaweed is floating above the stones and rust. I let light shine through the seaweed by increasing transparency with the OPACITY tool at 88% then the CURVES tool placed below the seaweed to brighten underlying layers.

Fig 9

Fig 10

By now it was looking quite good but still lacked something. I turned back to the blue morning shot of the mountain, and after playing around for a while inserted it below the X-ray and above the sunset shot, using the LIGHTEN blending mode. All of a sudden the seaweed was floating in water at the edge of a shallow pool. It only required for me to bend the seaweed a little using the WARP tool and I was satisfied with what I had.

Fig 11

In the final picture the X-ray is still visible in the background, part of it was copied, shifted, enlarged, coloured and warped, and is no longer recognisable as an X-ray but looks a little like some strange font – 1OO! The index word was Floating and the story is now in the image. There appears to be a painting or a photograph partly in the water – the original X-ray. Why is it there?

There’s enough mystery in the picture to keep me guessing for a while.



Chest 128 – Spes. An Exercise on Hope

8 Dec


Chest 128C

Chest 128; Spes. – An exercise on Hope

Dum spiro, spero – whilst I breathe, I hope.

Spes is the Latin word for hope, and from this comes spes phthisica the hope of the person afflicted with phthisis, otherwise known as consumption, now known as tuberculosis.

Tuberculosis was known as consumption, caused by Mycobacterium tuberculosis discovered by the microbiologist Robert Koch in 1885. At the time one in seven deaths in Europe was caused by this disease, there were no antibiotics, and the only way to control it was to isolate the patients in sanatoria.

It was in a hospital, previously a sanatorium, that I first worked on moving to England in 1975. We had only three TB drugs in routine use at the time, Streptomycin which also made the patients deaf by damaging their auditory nerves, Isoniazid which I doubt had any effect on the disease, and PAS, an aspirin derivative which was taken in large tablets that caused such painful stomach erosions that the patients would surreptitiously throw it out of the window killing the grass on the lawns outside.

It was at this hospital I encountered the euphoria of hope in young people dying of tuberculosis – spes phthisica. In the older times it was believed to be peculiar to consumptives in which physical wasting led to euphoric flowering and creative aspects of the soul; genius would burst forth. Many of the great poets dying of tuberculosis produced their best work in their final months of life. Keats  great output during the last year of life was thought to be directly due to consumption. Shelly, similarly. Alexander Dumas Fils (1852) wrote; ”It was the fashion to suffer from the lungs…. It was good form to spit blood after any emotion that was at all sensational, and to die before the age of thirty”.

My memory is of a young woman wracked with TB acquired during treatment for an autoimmune disease, with terrible arthritic joints, coughing blood, hardly able to breathe, smiling the entire time, discussing with me how to set a perfect dinner table, what glassware she would choose, and the menu she planned to prepare for her next dinner party. She passed on within a month.

In the background of this picture is a chest X-ray from a man with tuberculosis. In the foreground the rotten stump of a tree branch. The angle of the forked branch reminded me of the arms of a crucifix, into the corner I have inserted an eye of hope gazing toward heaven.



Feet – an exercise

19 Nov

As part of a development exercise I have been challenged to produce a picture of my feet.

Feet 3 J

Feet 3

These are my feet. I rather like that I can see my face in the left foot.

Feet 1 J

Feet 1

This version gives the impression of being underwater in a rather dirty pond.

Feet 4 J

Feet 4

I liked the warmth and focus of this version. It reminds me a little of the famous hands in the Sistine Chapel, though it looks nothing like.

Feet 5 J

Feet 5

The final picture incorporates my signature Chest X-ray and gives the whole composition a different feeling.

I know which one is my favourite, but would value the opinions of anyone who might read this. Please, critical comments are welcomed.




Chest 127; Asterixis

19 Nov
Chest 127  C

Chest 127; Asterixis

I have been thinking about lung function just recently because of a chest infection picked up on an airline flight. It started as ‘flu but soon went to my bronchi causing bronchitis. It has surprised me how much my exercise tolerance has been reduced, and I’m still hoping for a quick recovery. Today’s artwork arises out of these thoughts.

Asterixis, (meaning unable to keep still) is a medical term for flapping of the hands seen in metabolic diseases affecting the brain – encephalopathy – it is commonly seen in liver failure due to cirrhosis but can be due to respiratory failure.

The sight of a man – it was usually a man – lying in bed with hands flapping like little wings, gasping for breath, was one of the more disturbing sights I encountered as medical registrar in a respiratory unit. Chronic obstructive airways disease or emphysema; strongly associated with smoking tobacco, with congenital abnormalities of lung, and lung metabolism causes progressive damage to lung tissue with loss of ability to exchange Oxygen (O2) for Carbon Dioxide (CO2).

Slow loss of lung function means increasing breathlessness until the person comes to a point where the balance of O2 input to CO2 output is marginal. It only requires a small infection to knock them over into negative balance; they absorb only just enough O2 to survive and they cannot easily eliminate CO2.

After exercise anyone will be familiar with the sensation of increased drive to breathe more quickly. This reflex is largely due to rapid rise in CO2 in the blood that stimulates the brain to increase the breathing rate (it’s also due to other things, but I’m trying to keep this simple). But when that CO2 rise is gradual over years due to progressive lung damage the response is blunted. That means low oxygen levels become the main driver to control breathing rates. If Oxygen treatment is given to such a person, increased O2 in the brain takes away the stimulus to breathe, respiration slows, CO2 is not exhaled, allowing more to accumulate in the body. Eventually enough CO2 mounts up to cause brain toxicity. Hence asterixis – the brain toxicity of too much carbon dioxide.

This is a paradox. Of course if someone is desperately short of breath it is natural to give them Oxygen. BUT NOT in this situation because it can kill them.

There was one small comfort. A man would come to our ward in extremis, apparently massively distressed, in anguish, gasping for air. After treatment and before discharge I would ask what he could remember of his admission. The event and the suffering had always been wiped from his mind. That is one small blessing.

The X-ray in this image shows a man with chronic emphysema. A child can be seen running through the picture chasing her breath.




Chest 126; Meditation on The Cough by Counihan

7 Nov
Chest 126 C

Chest 126; A meditation on The Cough by Counihan

Noel Counihan (1913 – 1986) was one of Australia’s important artists, a social realist, political commentator, and a man with a deep understanding of social hardship in his time. His life is well documented, and the story of his address to the crowds from within a locked cage whilst the police had to cut him out is well known. I only want to talk about his artistic achievement with regard to The Cough… Stone Dust, (1947 © Estate of Noel Counihan). He illustrated the ordinary people, the workers, the downtrodden and unemployed in Australian society in the 1940s and 1950s, and no image is more heart searing than this lino-cut which depicts a miner with silicosis (pneumoconiosis) exhausted from coughing. This picture is used as the logo of The Silicosis Project, a major inter-disciplinary European research project in its struggle against silicosis . It is a new research project combining history, medicine, and social sciences. This project deals with one of the deadliest occupational diseases in history; silicosis, caused by inhalation of crystalline silica dust particles. The occupational disease is mainly due to mining in silica bearing rock, but also associated with other dusty occupations such as pottery.

I was brought up through the 1950s and 1960s on a copper mine in Zambia where silicosis was an important part of the average underground worker’s life. Regular X-rays and medical examinations by the Pneumoconiosis Board theoretically meant that a worker could lose his job if the disease was discovered. Looking back, with hindsight, it is obvious that the board was used to keep workers working as long as possible despite development of the disease. Compensation at the time was a pittance, and this was particularly true for black workers.

I have been moved by Counihan’s linocut which shows a miner wracked with cough, exactly as I saw men in our small town suffering, trying to catch their breath with the inflammatory, fibrotic lung disease.

The Counihan Estate has kindly granted permission to use the outline of this image in my work. I have subtracted all but the outlines from the original image and superimposed a formalised bourgeoise pattern typically seen in carpets of the middle classes in the 1940s and 1950s in order to draw a distinct contrast with the jagged outline of the working class miner depicted in cyanotic blue. I have further drawn roughly into the image to emphasise this. The Chest X-ray of a miner with pneumoconiosis is superimposed on the chest focussing on the lungs to provide the only bright colour in the image.

This picture will be published on my blog. I shall keep a copy for myself, but the picture is not for sale.


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