(Jeff_L) #1


Jenny Wright and Neil shah

tool. The qualities of tissue structure are more vari-
able in maxillofacial operations, and this is reflected
in the drawing. The tones reflect the steady, usually
slower division of more dense flesh or bone. Lighter
lines expresses the more fluid, smooth motion that
the surgeon uses when dissecting more ductile tis-
sue. This can be seen in the recordings of move-
ments using the Monopolar cauterising tool or
harmonic scalpel. The pencil strokes revealed the
direction of the movement of the tool as it separated
and uncovered structures. Small bleeds on the sur-
face, sealed with the point of the cauterising scalpel,
appeared as dark points, relating to the burnt tis-
sue as well as the tiny focussed halting movement
of the tool at a specific point. These marks appeared
as dynamic full stops as they follow the course of
venous or other tissue structures. The decisions of
the surgeon’s gesture and tool use are informed by
visual and tactile sensation. The small sketches are
a reflection of the surgeon’s decision-making and
attempt to mirror the surgical process.

While focussing on the quality of the incisions
made by surgical tools, images were made that
revealed some of the shapes of the tissues on which
the surgeon was working. In the case of the maxil-
lofacial surgery, a rich series of drawn marks follow-

ing the movement of the scalpel excising a tumour,
developed into an image revealing some of the
form of the tumour being removed. (Figure 2) As
the operations progressed, images were made that
conveyed something of the mass and texture of the
rather solid diseased tissue. Although the surgeon
was making incisions around the structure of the
tissue in order to remove it, mimetic drawn marks
made began to resemble the compact, dense shape
of the cancer being removed. To make the image
more readable sometimes, contour lines were added
to mark areas off the perimeter surface.

Understanding the haptic processes demon-
strated in the movement of surgical tool across tis-
sue became a key part of the dialogue. For Neil, this
allowed him to step outside the immediate activity
and consider the role of different kinds of percep-

tion as well as the acquisition and refinement of
skilful tool use in surgical procedures. Discussions
often centred on drawings that focussed on specific
movements at particular stages of an operation.

It was from these images that recording schemas
were devised, focussing on specific parts of an oper-
ation in order to analyze hand and tool use. This
was subsequently abandoned as the evolving com-

Figure 1. Wright Jenny (artist) Tongue tumour.
Image and detail from theatre sketchbook show-
ing cauterized areas. 15 x 22 cms Pencil on paper
Jan 2011

Figure 2. Wright Jenny (artist), Image from the-
atre sketchbook; Neck tumour tissue 01 6 x 6cms
Pencil drawing on paper, Jan 2011
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