Tag Archives: Hope

Shaken Baby

8 May
Shaken Baby J

Shaken baby syndrome

Probably the most insidiously traumatic aspect of my career has been dealing with Non-Accidental Injury to children, particularly Shaken Baby Syndrome (SBS). In one appointment approximately 50 suspected cases were seen each year. Not all were positive, but many required a legal report be provided to Social Services, the police, and the courts. Court attendance to give evidence as professional or expert witness resulted ten to 15 times a year.

I was reading X-rays showing dreadful injuries perpetrated upon infants, sometimes only a few weeks old. Then in court, coped with lawyers whose sole task was to throw doubt upon the evidence, alleging prejudice, lies, error, stupidity, or worse. It took years to learn to deflect personal attacks whilst remaining objective. An expert witness must explain to the jury what they see, and objectively interpret evidence without favour. So evidence may help either prosecution or defendant irrespective of who has called the witness to court.

At that time much scientific evidence to support what seemed self-evident was being discovered, it was absolutely essential to keep up to date. But some aspects of SBS cannot be verified by experiment (it’s impossible, not to mention unethical, to shake a baby just to see what happens). Forensic interpretation from an X-ray of the kind of forces that might have caused injury, such as multiple rib fractures, derives from deduction, analysis of damage from observed (and measureable) accidental situations, and occasionally from confessions of perpetrators themselves – though not always reliable! Lawyers are quick to exploit those aspects that can’t be tested!

Although multiple fractures are heart-breaking to see, most heal and disappear in time. A more tragic aspect was to follow a shaken baby through the years and watch the little brain fail to develop normally knowing that the child will be disabled for life.

In this picture I’ve included the chest X-ray of a child with fractured ribs; a collar-bone fracture is easily seen. The layers were hand-painted and filtered to give a jagged rather violent effect. There is only one photograph – a candle – symbolising my hope that the realisation of harm that shaking does to an infant brain, through dissemination of information and carer education, will help prevent these horrendous injuries to infants.


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.



Grim Reaper series No 4; Time

12 Nov

I have been away exploring North India for a while and returned full of images that stuff my much belaboured brain. Much time is taken up at present in construction of the Punch and Judy project which is nearing completion of the construction but  requires a lot of learning lines and puppetry techniques. Sooner or later I shall have to post a video, meanwhile, here is my latest image from the Death series.

This image explores the time of transition, the movement from life into death; a process feared by many. Awareness of the fact that our time on earth will be short is forced upon the mind when becoming aware of impending death. In this situation it is essential to plan, to think ahead, in order to fashion the best life possible out of time remaining.
The index X-ray in this picture was from a lady with a large collection of fluid in her right pleural space (the space around the lung inside the thorax) caused by advanced mesothelioma. Mesothelioma is usually due to exposure with asbestos dust. This lady did not respond to treatment and the underlying lung collapsed. There was also invasion into the lung, ribs, the right chest wall, and breast. The prognosis for a new diagnosis of mesothelioma is typically about 18 months though cases can live longer, but advanced cases such as this have a much shorter life expectancy.
Component parts of the image include a human skull decorated in a primitive society which matches the theme of death in this series. The strong patterns including the spiral on the right arise from a brass plaque in an Indian temple to the worship of Kali the originator and devourer of all things. In the end it is time (Sanskrit; Kala काल) that both originates and devours all things.

Chest 111 Time

Chest 111; Time

Chest 64; Two kinds of hope

12 May


In this image I tried to make a picture both simple (well, relatively so, most of my images are quite busy), and at the same time be powerful enough to carry a deeper meaning. The cross crept in almost by accident, I’d intended to exclude it, it was visible on the original picture; wooden tools from a commercial fishing boat leaning against a shack wall in the sun. In the final cut the cross seemed to carry a lot of weight, so not only was it left in, but became the main focus. Hope is a recurring feature of my images – spes phthisica a condition of euphoria described in patients dying of lung disease (mainly TB). I saw it in a close relative dying of cancer, in her last week happily purchasing embroideries and tapestries needing months to finish, and planning years into the future.

The chest X-ray was reduced to its minimal parts, it was from a lady with tubercular infection of the lungs and complications –  fibrosis, and a pneumothorax. What is left on the picture just retains the diagnostic elements albeit minimalized – another variation from my usual style which is often to obscure the diagnosis amongst the design (though not always).

In this image it is hard to escape the cross, all its social and religious connotations as well as its association with the disease of tuberculosis. I realised the viewer has to deal with that by bringing their own associations to it. 

By pure serendipity the image contains two Chinese characters 大 女 which mean ‘Big’and ‘Girl’respectively. See if you can pick them up.

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