it’s rarely purely physical . . . rarely purely on the surface. But the longer I sit here as a GP the more you realise it’s not just the physical, it’s the physical and the emotional and that the physical goes on under the surface as well. For me it’s always about the exploration. So [it’s about] listening and reflecting back and trying to work out what it is that’s going on for each individual person, which is often about something inside, so it’s about how you get below the surface, for me anyway.
With this kind of sensitivity O’Brien already knew the potential that pictures have to stimulate or guide such explorations and she already had a few in her surgery, all depicting nature in some form:
one was of a desert and that was an invitation to explore as far as I was concerned, no people, just a desert. Then there was another picture of St Michael’s Mount with lots of people walking on a pilgrimage, so I said that’s people on a journey, and then there was a picture of a bird taking off on a lake; it was talking about new beginnings.
So when there was an opportunity to reconfigure her surgery she took the opportunity to see whether Blake might like to make some new work, knowing as he did the context. Ever responsive to this context, that of a family doctor’s surgery, he came up with four ideas, which would reflect different life stages of the patients.
In his words:
In a sense the point of it being four pictures, [is that] the perspective goes through them, they are continuous through each other and I think the fact that each picture is only one colour is a way of telling you that this isn’t just a picture that I went out and drew, and filled in the colours as they actually were, but that it has another purpose so to speak. The orangey one is the more youthful one, perhaps the green is more active, although [the woman] is going a little bit into reflection and then this is the most comfortable autumnal [brown] and these are various members of the family at different ages so you ought to be able to find somebody about your age in there somewhere I think. Then the advantage of having separate pictures is that you can move those colours, it is not just a photograph of what is happening there on that day and then it also has the advantage that one picture, the bottom right, [blue one] is much lower. You are actually going down to darkness. Technically speaking she’s having a swim but you are going into a different colour-way and a different mood so that was to try and move fairly naturally from an everyday buzz of children and so on, or this young couple to . . . she is sort of diving into herself really I suppose, or something like that. Which is why I wanted them to be separate pictures so that they have a slightly different atmosphere . . . . it’s the same picture but it’s a different day.
As we know, swimming is not Blake’s ‘thing’ but its symbolic value, as suggested above, has always been useful, and in the case of the surgery pictures, there was an extra reason to use it as a theme, since it was the sport that Dr O’Brien practises: ‘For me it’s also the journey . . . my own personal journey has involved swimming . . . You do have a knack of putting us all in the pictures, and we can all see it.’ She then adds that the swimming picture is actually the one that she herself used to see, as it hung opposite the seat where the patients sat: ‘so it’s more of an inspiration to me, quite a support’. The notion that such works are as much for the staff who see them all the time as for the patients who only visit occasionally is a key one. Everyone in the healthcare system needs this kind of encouragement and understanding.
Two more of these projects can be explored in greater detail to see how an illustrator responds to this very different kind of brief. A text is the brief for an illustrated book, a selling idea for a billboard advert, a political situation for a cartoon; in all these cases there is a specific to be dealt with. But the brief for the hospital projects is often very broad, so broad as to be almost non-existent: when Blake is invited to create a scheme for a hospital setting he is often given carte blanche (although he will know what and where the available spaces are) – as he says ‘the brief doesn’t really exist, I invent it.’ This is partly because the commissioning of art is sometimes an unfamiliar experience for the clinicians or managers who take on the task.
So with a new hospital commission there are many options for an artist: he could think about showing the hospital itself, as a busy institution at work, or as a building in a location; he could focus on filling a space in a particular department with safely pleasant images of the world outside: the kind of flowered and fruited still lives, or the watery landscapes you see improving the environment of blank corridors in many institutions; or he could focus more closely and illustrate the conditions the department is trying to cure or alleviate, in the way that artist and scientist David Goodsell has done with his glowing, minutely executed watercolours of diseased cells; he could take the staff as a subject, showing reassuring interactions between them and patients, in theatres, wards and consulting rooms.
In fact Blake’s gaze is often more directed towards the patients and families. Not so much on representing the ‘disease journey’, as artists such as Michele Angelo Petrone did in his often-bleak, intensely coloured metaphors of physical suffering, but instead on what it might be like to be a patient in what is, for many, an alienating new environment. As a patient, your stable self is under a dual attack: not only are you sick enough to be in hospital in the first place, but you are also away from familiar people and things, the latter bringing extra anxiety if you are a child. This is where Blake starts.
When Blake worked on his project for the Vincent Square Eating Disorder Clinic it was still situated in the square of the same name, near London’s Victoria Station. Now relocated in Kensington, the clinic diagnoses and treats men and women (in practice often young women) with eating disorders of various kinds. These were also big unknowns for Blake, so, before starting work, he went to talk to the service users and staff there. He found this both a distressing and a useful experience: distressing to see young people so extremely ill but useful because he learned that what they often had in common was a fastidious attitude to life in general, not just to food, and this was something he could address in his unobssessive drawing style, which in this case he put to specially relaxed and generous use with a quill pen. He was also relieved to find a robust sense of humour: meeting the service manager and one or two young women for an initial consultation he asked them if there were any ‘no-go’ areas as far as the content of the works was concerned. ‘You can draw anything you like,’ said one of the young women, ‘but not too much food; I’ve got enough on my plate already.’ Armed with this thought, but with a focus on the not too much, Blake made over forty drawings, which were to hang in the public spaces of the unit.
Of all Blake’s hospital drawings these seem to me to have the most deliberately therapeutic intent: they start from a position of understanding: the girl in paralysed indecision in front of the clothes mountain, or desperately trying to get a clean line on her lipstick – these are things that the patients feel do really represent them. But the drawings go much further, they suggest other ways of living. In some of the images Blake makes the most basic elements of daily life seem enjoyable, even if not always perfect: you can go for a companionable walk in the rain, you can feed birds on your window-sill if you don’t have a garden – (amazingly, Blake says, he later found out that there had been a patient who had actually invited the pigeons into her bedroom); you can have a great night in, slumped on an old sofa with a book and a good friend to do your hair, even if you don’t have a flat stomach. And Blake managed to slip in the food message, without ever lecturing, by including animals, or cookery or gardening scenes: a dog sitting up for a biscuit, people buying fruit in a street-market, or the pleasure of pulling carrots in the vegetable plot. That the effect was indeed therapeutic is evidenced by a written response to the work by an artist who was also a former eating-disorder patient: she looks at the examples of food-sharing, both human to animal, as in this picture with cats, and human with human, as in this apple-picking session:
‘The association between offering food and love, accepting food and trust, works to a very profound yet unintrusive level . . . Attending to pets also means reaching outside ourselves, nurturing them means recognizing and becoming sensitive to other’s primary needs . . .’ and ‘It is a fine summer’s day and nothing looks more inviting than enjoying together a juicy, freshly picked apple . . . as we are only spectators and our presence is not demanded or expected, we feel under no pressure to share the characters’ activities, yet secretly we wish we were having such a pleasant time.’
My own work with people and pictures in hospital settings4 has repeatedly shown me that patients relate to images in a heightened way: people so often project their own situation into a work of art, even one with no therapeutic connotations. So it is no surprise when pictures, in which the perspective of the patients has been considered and understood so imaginatively, manage to speak to them so directly. As the arts consultant Alison Cole once said to Blake of his work in such fields: ‘People want you to reach out for them: you should be given a medal for services to outreach.’
The Eating Disorders Unit was, in spite of Blake’s positive interventions, a place of serious illness – indeed one of the patients he met on his first visit died not very long afterwards although she did live long enough to see her much-loved dog, of which she sent Blake a photo, appear in one of the pictures, and it is now a kind of memorial. But in the new maternity unit at the Centre Hospitalier Universitaire at Angers in western France, the ‘patients’ would not on the whole be ill, although of course many would be feeling pain, and perhaps anxiety. The project, which I worked on as a consultant, was apparently a first in France: the first time that an artist had been involved at the early stages of the design of a hospital building, and it was a huge project in the end, with 50 works being displayed throughout the new building. Anne Riou-Chartier, the hospital’s ‘cultural adviser’, had been looking for an artist to animate the planned new building, and found Blake through Patrice Marie, at the time working at the French Ministry of Culture. Marie had previously implemented a forward-looking government initiative called ‘Culture à l’Hôpital’, which required every French hospital to create a partnership with at least one local arts organization. At Angers there was already a flourishing arts environment with exhibitions and projects in children’s wards. But the size of the maternity scheme was of another order.
Blake had never visited a maternity hospital before – the nearest he had got to such a place, he once implied in a quiet aside, was when accompanying a friend who was to have a termination. On our first visit to Angers we were shown around the old maternity unit (then still in use), so that Blake would have a sense of the environment he would be working with, and to meet the staff who would be working in the midst of his images.
That first meeting started well, with a four-course lunch accompanied by several good wines, in a private staff dining room (we knew we were in France). But at the business meeting round a table, which included the architects, hospital management and clinical staff, the atmosphere was much more formally French. The architects seemed reasonably sympathetic to the idea of an artist ‘completing’ their building but I felt that the clinical team, especially the male consultants, were yet to be convinced, or maybe their minds were just elsewhere. Blake himself confessed to momentarily feeling ‘quite intimidated’ when, at the second or third meeting, we were faced with a barrage of midwives, strong and opinionated women who brought all their knowledge and experience of women giving birth to his place of unknowing on the subject. But, as Blake says: ‘Little by little I became immersed in the atmosphere of the hospital through my conversations with the teams.’ Immersion was the right word to use here as Blake decided that water would be the setting for his figures – alluding to the amniotic fluid that surrounds the baby, to the fact that newborn babies have a swimming instinct, as well as to the waters of the River Maine that flow past the hospital. As a result, the drawings have a gentle French rococo swirl that has reminded some viewers of Boucher or Fragonard.
Blake’s ability to collaborate with people and place was recognized by one of the more sceptical consultants who, by the end of the project, felt able to say: ‘Blake didn’t just bring his work with him, he was inspired by the spaces and the people who work in them.’ He did respond to the place, and he did listen to the staff: when one or two of the team argued that fathers should be represented in at least some of the works, he made new drawings in which father–baby interactions were just as real and as moving as the baby–mother ones. When, at another point, for cultural reasons, reservations were expressed about a drawing in which the mother’s rather spread-out legs made the pubic hair very prominent, Blake accepted that it would not feature in the final scheme. At another moment, a question arose about whether Blake would make drawings for a room which would be used for late medical terminations of pregnancy: a room where a mother would be delivering a dead baby. He readily agreed to this and when he presented several drawings, he listened carefully to the comments of the clinical teams. There was a long debate about which of the drawings he showed them would best achieve the sense of solace that he wanted to create for this particular space. This one which shows a young woman being supported by an older one (in midwife role) was, revealingly, dismissed by one male member of staff as looking like ‘two lesbians’. But the midwives had a very different take. In this image they saw not only the immense difficulties faced by the mother, expressed by the thick bank of seaweed in the foreground (also there ‘to respect her modesty’, as Blake later said), but also the importance of their own role as guides and helpers on this toughest of journeys. Needless to say, their view prevailed.
For the small room next door where the parents ‘say goodbye’ to their child (‘We do consider them as parents,’ said one of the midwives, ‘parents of a child who hasn’t lived’), Blake came up with two moving metaphors for the situation, keeping the water theme.
More serious discussion followed, ending in a decision to hang both of them; no one could decide which was more apt: the floating bouquet, which had something of a little body drifting away about it, or the single flowers, more suggestive of finality accepted.
By this time, it was clear that Blake’s work and his attitude had overcome any uncertainties which may have been present at the beginning, and the team suggested to him that 50 drawings to cover every room and corridor might not be quite enough – why didn’t he think of doing a few images for the glass façade too? This offer was a defining moment for Blake: a chance to mark the ship-like building, with its wave roof, with the fluid lines of his aquatic ideas. Five of these six images were head-and-shoulder vignettes of mothers with babies, and the last was a woman on her own, reflecting the fact that this unit also treated gynaecological emergencies.
Blake saw this also as an opportunity to give the passing public a sense of what was inside, because, of course, only expectant mothers and their birth-partners would actually see the scheme.
Remembering how this project developed, I think it was a model collaboration: there were no grandiose expectations on either side but a genuine mutual curiosity and a growing sense of how everyone – the artist, the client and future audiences – would benefit from these works. Their power to express a range of feelings surrounding the birth of a child was apparent to everyone, and Blake’s willingness to speak French, at internal meetings but also in public to sponsors and local officials, and his quiet humour and charm, all these things made for a truly productive and warm working relationship. Within it, the purpose of the scheme, to make the users of the maternity services feel as welcome and calm as possible in the intensity of the birth experience, was always there in front of everyone. This atmosphere was also picked up by the staff member who managed the neonatal ward where premature or very sick babies were nursed. Access to this ward was through what this lady described as a ‘triste couloir’ (a sad corridor), along which newly delivered mothers would need to travel to see
their babies. This manager, keen for the scheme to extend to her domain, asked Blake whether he might be able to make some images to animate this bleak space, and so perhaps also to console the mothers who were without their babies. Blake agreed without hesitating and produced these gentle metaphors, the idea here being that although the baby is separated from the mother, she knows that it will be properly and lovingly taken care of.
The warmth of the whole project was exemplified in a moment which Blake recalls with special pleasure, near the completion of the building, when Edmond Vapaille, whose job title is ‘chef du pôle des ressources matérielles’ (he looks after the money), said seriously, ‘There’s one very important thing.’ We held our breath. Had the money run out? Did the hospital top brass not like the drawings? But no, to this hardened administrator the really important thing was ‘the exchange of look between the mothers and babies’ in the drawings.
Anne Riou-Chartier, reflecting on the project, said:
It’s not easy for someone from outside to go into a hospital, still less into a ward. It’s like going into the home of a person who is fragile, sensitive and frail, you’re always afraid you might break something. Quentin Blake understood this straight away. He pushed open the doors to the maternity unit [at the CHU Angers] with great care and attention, both for the mothers and future fathers and the babies but also for the midwives, the doctors and the nurses. His way of observing and listening allowed him to be welcomed into the kind of healthcare setting, which rarely sees artists at work . . .
Quentin Blake: In the Theatre of the Imagination Page 21
