Digital Insides

# 1 Ida Levine

I:All my insides revealed to you. It’s a bit embarrassing. On the one hand it’s medical but it’s also really personal. It’s me, but it’s also not me. We don’t have a language to judge our insides but for the outside we have a script, especially for women’s bodies.  I went to the doctor with a lump under my underarm, the doctor said it was nothing but referred me eventually to get a scan. To get the evidence of the suspicion.

L : The ability to scan people so easily is turning medicine on its head. Doctors used to infer from the outside. Now everything can be verified from the inside.

I: It was such a long process. I wasn’t sure where to get the results. I went to my GP but she couldn’t interpret them. She said I had very high levels of something so I went home and googled it and found out I probably had cancer. Three years before I’d had a mammogram and when they looked back they saw it was the beginning of a tumour but at the time had decided it was just a shadow. I had thought something was wrong, I had a strong sense that something was wrong but I didn’t trust it because the scans showed I was OK. I trusted the power of the image and the doctor to give a definitive answer.

L: Imaging leaves a trace of what’s already happened. Not just of the shadow but of the failure to act on the shadow. But then thresholds are complicated. We all have shadows. There is variation between different bodies and alot of complexity in what is normal.

I : I remember when they tried to get the biopsy, I sweated profusely out of fear. I felt embarrassed. There was nothing I could do about it. You are totally at the mercy of the people and the process. You need to comply so they can get what they need. Later the care I had was absolutely amazing.  The doctor looks at the images. Just another spine, just another breast. For the patient it’s a very personal story. My experience is that they give you the results but you never see the images.

***

I: With MRI scans I have to take a relaxant. Even now if I hear a certain kind of banging it distresses me. Recently I heard a noise like MRI and it took me right back.

L: When I had an MRI I used the panic button.

I: That’s brilliant – a rebel, I feel like a have to be a good patient. The waiting is the hardest thing. They know! You have cancer and you don’t know. What is that? A tree trunk! Just chop me! Is that my intestines? That’s my spine?! …..I find that quite religious. The ribs are what make it so distinct. It’s ugly and beautiful at the same time. I look like I’m quite emaciated. Every time I see these images I am surprised and fascinated all over again. They are beautiful even though I don’t always know what I’m looking at. There’s kind of a darkness about them.

L: Yes, we are struggling with a language to discuss them. Looking at these images, with all the dates, it’s a constant going forward.

I: That’s like an organ, is that my heart? Now you’re going to find out I don’t know much about my anatomy. They’re like life drawings.

L: It feels like there is so much light inside your body.

I: It’s ghost-like.

L: Yes that’s just the word for it. Like a spectre. It’s a kind of trace. Ever since the very first x-ray there has been a public fascination with the look of x-rays.

I: Do you not think that’s just the fascination with the inside of our bodies?

L: Yes I think it is, but it’s coupled with the way that it’s visualised. We can’t imagine the inside of our bodies differently because we’ve never seen them differently.

I: Our knowledge of the inside of our body comes to us as images. We fill up a space, we are presented within this rectangle. It’s close-up and symmetrical. This feels a little bit narcissistic, a little bit me, me, me. If we were looking at photographs, photographs of the external me, how different this whole experience would be. I would have a totally different reaction; I’d find them unbearable to look at. I wouldn’t let you look at them either.

L: But this is really personal too isn’t it?

I: On some level yes it’s more personal, because it’s internal, it’s inside me and it’s about illness and so many things. And yet there isn’t the judgement that goes with looking at our outsides, our appearance. I’m not judging my spinal cord, like ‘oh, that’s not a very pretty spinal cord’.

L: I wonder I whether that might change, that medical images might become so culturally familiar that we comment on their appearance? I mean, think of how many billions or trillions of medical images there must be. There are these epic repositories of images of us on servers all round the world. I can’t think of anything comparable can you? Billions of images unseen by the public. I think that will start to change, that they will start to leak into the public, and to circulate around so that we start to get used to seeing them.

I: I think anybody can identify with medical imaging, I think the x-ray is the most imprinted image on our minds.

L: The images we’ve found the most shocking are the 3D images because that’s something that we haven’t seen before. It’s also somehow closer to the body than the x-rays.

I: Is that my hand? I don’t know, what is that? It looks like fingers almost. Like digits.

L: Maybe it is, but there are too many, 1,2,3,4,5,6…. but it could be both your hands? It’s like some kind of appendage.

I: Maybe it’s part of the machinery? You know how you can see those illustrations of mattresses? And they show all the different layers with the textures and shapes.

L: You’re well sprung! These images look more like a photograph than a medical scan.

I: Yes they are identifiable, more recognisable, more of a likeness.

L: Some of the other images were so abstract. It doesn’t feel like a representation of anything, not anything known anyway.

I : But there’s still a link back to me. I am fascinated by my own scans even though I can’t quite identify what they all are. Would I be so fascinated by looking at somebody else’s? Knowing the date of these images has suddenly given them so much more meaning. This is when they were doing the mammotomy biopsy thing, punching these long things inside my breasts. It was such an unpleasant experience and I feel like we can see that in these images. This visually represents the experience. This is not a pleasing thing to look at.

L: It appears as though the machine that imaged you has somehow ended up being in the image.

I: Like science fiction.

L: Not like a body.

I: I don’t remember the doctors ever showing me these images. I have a lot of respect for the way the doctors gave me information in small doses. Apart from this awful mammotomy the level of care I had was amazing. Are those are the biopsy samples. On glass slides?

L: These images seem like a record of the imaging process itself.

I: Bilateral mammograms. Yes I remember this being a really traumatic process. So this is all part of that horrendous day, that was the beginning of the journey. With a scan you just lie there and whatever happens, happens; whereas this was a very, physical, manoeuvring for two hours.

L: That looks like it might be some kind of failure? The image is white, it doesn’t give any information. Like they’ve over-exposed it.

I: And you do wonder, because I did afterwards, was he incompetent? Although I kind of doubt it because if there had been any negligence or incompetence, I can’t imagine they would include the evidence.

L: That’s such an intriguing point. The way scans record the patient but also in a way record the actions of the radiographer. It’s a trace of the whole event. But then, oh look at that.

I:Oooo
(Both gasp)

L:It’s so round.

I: It’s round but then the nipple is different, a different hue. That’s incredible.

L: Lots of interventions which were previously done by surgeons are now done by radiologists who are doing image- guided interventions, using live screens. So they can get in without opening you up, they can use these tiny wires all because they can image the inside. Every intervention leaves a trace of itself behind, becomes part of the records.

I: It’s like them having someone looking over their shoulder? If you put it in the context of CCTV and the whole voyeuristic nature of our society now, now it’s happening on the inside and the outside.

L: Yes, a penetration beneath every layer and every surface. There’s nothing left unseen.

I: The stuff we don’t normally see it. Imagine if these become like selfies.

L: I think that because we are so image obsessed, it seems almost inevitable that in the not so distant future that there will be some kind of claiming of this kind of imagery outside of medicine.

I: Can you imagine?

L: We all have the right to access our medical images, though we don’t own them.

I: But do you think that would concern people? All that information, kept in databases. What if I had a new job and they were entitled to know that I had breast cancer? So is that a cross-section? So that would be my spine, there’s something very satisfying about that, it’s like a lava lamp. The kind of glooping, separating and then it all comes together.

L : I didn’t expect to see so much movement in all these medical images, we are constantly being taken through the body. One of the things that surprises is the lack of detail in the image. When you go in close the clarity just disappears. They have to keep the file sizes small enough that the scans are quick and the file sizes not too big.

I: Well there’s a lack of detail to us, because we don’t know what we’re looking for.

L : Yes the gaps. Air is black, and water is white.

I: Oh My God look at that. Suddenly you can identify what it is. Look how clearly you can see my breasts now. What is that?

L: Your arm socket?

I: We can recognise it. It suddenly something familiar. But totally visually alien as well. That’s just like ham, you know it’s like, there’s my ham. Those must be organs. What is that?

L: It’s an endless relation between what you know and what you don’t know. We are enjoying it when we recognise something but then there’s also this constant sort of excitement of uncertainty.

I: OMG OMG What is that? OMG OMG SHITTT. So alien.

L: That’s like a carcass that has been ravaged by animals.

I: Fucking extraordinary. What are the ribs holding? This would be so less interesting if it wasn’t me. It would become about the technology. There’s nothing to identify if that’s me or not. I don’t mean to sound so me, me, me but that’s the whole point of this. In a way we’re kind of used to these images now – it’s funny how we adapt so quickly.

L: Oh it’s just endless. So now we’ve generated further data, further ‘Lianes’. You look thermal, like you are all heat. Or an insect. Look at the ribs. They are your ribs – they are so perfect. Oh, now it looks like you are full of worms.

I: So all the things we bring to any image in life – our history, our knowledge, our understanding of art, our experiences of death and cancer and all those things – all of it comes in when you look at these images doesn’t it? But also it’s about the aesthetics isn’t it?

L: Because there’s no diagnostic possibility.

I: Well there might be but we don’t know about it.

L: We can’t bring that to the image can we? We’re not seeing the bones anymore. You’re solid.

I: I look like pig meat. That might be the top of my legs, filling up that space. It is much more fluid than solid. It looks a bit like a Francis Bacon painting as well.

L: So we looked a ST002, and there were 63 images and we looked at SE001. And this is ST003. Am I confusing you?

I: I’m kind of not really listening. I’m leaving that to you. I’m being very passive.

***

L: Okay so you were saying?

I: About the sexualisation of it. Suddenly. Not that they are sexy but they are suddenly very fleshy breasts. Up until this point there has been nothing sexual about this at all.

L: Yes and image have been so complicit in the objectification of breasts. It would be very different if we were looking at your head that had been reconstructed, without any suggestion of sexualised anatomy.

I: But also this is quite transparent and ephemeral like it’s about to disappear. That I find excruciating to look at.

L: The frontal view?

I: Yeah almost like that angle is so embarrassing, it feels so …

L: Exposing?

I: Exposing. Seriously please remember that I was leaning forward. You don’t care, I know you don’t care (laughs) if you ever show them to anybody you say ‘she was leaning forward!’. I am lying on my stomach and my breasts are down through these holes in the bed. These are MRI scans. That’s like a soufflé.

L: You as a cloud. That’s like something appearing out of the sky.

I: Like a UFO.

L: But it’s not very clear is it?

I: Again no, well not to us.

L: We are moving through the body.

I: It’s like we’re physically scanning, we’re getting the sense of the process by doing this. Travelling through the body.

L: Yes and getting so drawn in. These images enable us to reconsider the process or the body. To think again about what’s happened. Or what’s happening.

I: All these different realities in the same thing.

L: Multiple ways of generating Liane Harris’s breasts. But also as you’ve had a double mastectomy, we can see the absence in the after images.

I: Yeah I suppose they are so external. It’s gone black.

L: It is so digital…..your body emerges and recedes from the black space on the screen.

I: It looks like it’s going through mercury. It is hypnotic.

L: It is compulsive too because it’s based on what actually happened. Even though it feels like fiction.

I: On one level these are very soothing. Growth, growth, growth. It’s like a narrative, a story, it has a beginning, a middle and an end. From dust to dust.

L: Like a constant regeneration isn’t it?

I: It would be beautiful to have the aerial and the side views at the same time.

L: This is really earthy.

I: So now it’s doing a bit of a turning. I’m an animation.

L: It’s a rotating fragment. It would be good to do that with your whole torso. Do you want to have a go now at doing that now or should we call it a day?

I: I think we should call it a day.

L: It feels like we have ended up so far from where we started.