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Maddy Rice

KIE Bioethics Symposium

April 2, 2018

Discarded Narratives

When a patient checks out of a hospital room, that room must be reset to absolute neutral.

Staff comes in to strip the beds, throw out tissue boxes, change all the bathroom toiletries, and

dispose of anything that is not furniture or wallpaper. Like the patients themselves, the objects of

the room are transient, and they are disposed of following every occupant. Pieces of the patient

story scatter to the wind—or to the landfill—as disposable items are continuously replaced and

discarded. Although there is a robust tradition of repurposing certain types of trash for

communicative art, medical waste has been largely excluded. However, due to the intimate

nature of its relationship to the body, medical waste represents a relatively unexplored frontier

for a new genre of patient storytelling.

Western society is integrally linked to disposable culture and the production of waste, and

there exists a longstanding tradition of reclaiming discarded material for artworks, thereby

reinstilling value in waste materials. The massive increase of post-industrial trash accumulation

is a modern phenomenon, but disposability and waste production is as old as society,

specifically, as old as social stratification. Those at the bottom of the socioeconomic ladder must

repair, rather than rebuy items, so the ability to dispose and produce waste becomes a signifier of

wealth and success.1 Therefore, there is a socially reinforced motive to produce waste and

participate in disposable culture, despite negative impacts on the planet and personal finance.

The lifecycle of objects, their creation and destruction, reflects the society that produces them,

and in the case of medical waste, disgust and forgetfulness regarding medical garbage could

1 Whiteley, Gillian. Junk: Art and the Politics of Trash. London, England: I.B. Tauris, 2011, 15.

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indicate a similar disregard for the patient narrative in an ableist society. Stories of discarded

items exist in special proximity to the stories we tell about ourselves. Examining those stories

breaks down and reclaims discarded narratives and deconstructs the toxic cycle of waste

accumulation.

Modern artists already engage with trash as an analytical tool. From Tracy Emin’s My

Bed (1998) to Tim Noble and Susan Webster’s shadow sculptures (1998), works from waste are

meant to reflect human relationships and timelines through what is left behind along the way. In

these contexts, the artists still treat their media as relics, items that take on new meaning, but not

necessarily new life. In My Bed (Image A), discarded items surrounding an unmade bed tell the

story of a person, giving clues about her life and character.2 By contrast, Noble and Webster use

trash to create images that stand separate of the trash itself (Image B).3 In each of these works,

the trash is a tool used to tell a story about another character, whether it be a young woman

experiencing heartbreak, or a pair of men sitting back to back. Trash outlines their stories, but

does not participate in them. Dario Tironi’s trash sculptures (2016; Image C), however, take the

metaphor of discarded objects as narrative tools and extend it to a pataphorical story about the

agency and life of trash.4 Discarded objects in Tironi’s works define not only the characters they

create, but the personified existence of a material afterlife. The collection of objects that make up

Ragazzina Seduta5 (Little Girl Sitting) make up her eyes and nose, the slightly slouched and

defensive posture, the turned, inquisitive perspective. The individual items themselves embody

2 “Rea, Naomi. Naomi Rea to Artnet newsgroup, "“Turner Was a Really Raunchy Man”: Tracey Emin on Why Her Infamous ‘My Bed’ Is Really like a JMW Turner Painting," October 13, 2017. Accessed December 15, 2017. https://news.artnet.com/exhibitions/tracey-emin-bed-margate-1115603.3 Noble, Tim, and Susan Webster. Dirty White Trash (With Gulls). 1998. Photograph. Accessed December 15, 2017. http://www.thisismarvelous.com/amazing-shadow-sculptures-by-tim-noble-and-sue-webster/.4 "Dario Tironi, Ragazzina Seduta, 2016." Artsy.com. Accessed December 15, 2017. https://www.artsy.net/artwork/dario-tironi-ragazzina-seduta.5 "Dario Tironi, Ragazzina Seduta, 2016." Artsy.com. Accessed December 15, 2017. https://www.artsy.net/artwork/dario-tironi-ragazzina-seduta.

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the character rather than outline the character. Trash becomes, rather than creates, the central

figure. Ragazzina Seduta and her fellow trash sculpture people return from the landfill afterlife to

act human, and thereby assert the connection between society and the items it discards—the

character in refuse. All of these trash-works demonstrate the precedent of trash in ‘fine art’ and

highlight different angles to garbage-based storytelling.

Although garbage in general has been elevated to the realm of ‘fine art,’ medical waste

carries stigmas and taboos related to illness and bodily functions that set it apart from other types

of garbage. Animals are naturally repulsed by bodily fluids, and medical waste associated with

blood or spit or mucus carries that taboo; one might think here of the scandal caused by Andres

Serrano’s Piss Christ of 1987. Blood carries a weighty stigma, and instruments meant to interact

with blood—needles, bandages, gauze, even the packages they come in—are stigmatized.

Medical trash is both more personal and more repulsive. Blood is traditionally associated with

disease and contagion, especially HIV/AIDS, and also with the identity of the person the blood

comes from.6 For that reason, blood-related items (even if not actually bloody) are contaminated

by the pathological connotations of blood. Additionally, the blood is contaminated by the

disposability of trash, implying the disposability of the person by proxy. Hypodermic needles,

even before use, when they are completely sterile, have a certain, viscerally unpleasant quality.

Medical waste as a whole, however, is not a threat to public health, with the WHO reporting that

85% of medical waste is non hazardous.7 Medical waste, still, is specially stigmatized, specially

charged, and specially excluded from the world of ‘fine art.’ It is something to pass through

human consciousness and cease to exist, as the implications of its actual afterlife in biohazard

6 Kuppers, Petra. The Scar of Visibility. Minneapolis, MN: University of Minnesota Press, 2007, 112.7 World Health Organization. "Health-Care Waste." Who.int. Last modified November 2015. Accessed December 16, 2017. http://www.who.int/mediacentre/factsheets/fs253/en/.

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bins and incinerators, or re-entering the environment carrying blood or DNA or painful

memories, are too unpleasant.

While medical garbage suffers for its viscerality, that intimate relationship to the physical

experience of illness affords it the unique potential to represent the illness experience and track

the timeline of disease. The same factors that make medical garbage uniquely repulsive—the

association with the visceral body and the illness experience—charge it with emotive power.

Objects present during terrible experiences can remain traumatic signifiers of those experiences,

but they are also in a unique position to explain or symbolize those experiences in ways that

communicate a productive message or facilitate healing. All medical treatment involves medical

waste, such as suture kits, latex gloves, pill bottles, but patients in clinical settings do not always

see or have access to trash produced via treatment. Chronic illnesses, however, that include at-

home treatment, allow medical garbage to accumulate in the patient’s own living space and

require the patient to interact with and dispose of the accumulated waste. That is why, in an

already small genre of medical-trash art, diabetes takes up a disproportionate amount of space. A

diabetic constantly witnesses accumulation of needles, packaging, bandages, and other

accoutrement of their condition, priming them to consider and reinterpret those disposable items.

Agne Kisonaite is a modern painter, sculptor, and type-1 diabetic. Her artwork is highly

material, making use of hand-woven carpet and cosmetic packaging to express messages about

contemporary femininity. Her current project is a 3m tall sculpture, Diabetes (2017; IMAGE D),

depicting a woman sitting and leaning over to administer an insulin injection.8 The sculpture is

made of discarded 5000 insulin syringes collected from the artist and other type-1 diabetics.9 The

sculpture depicts not only a behavioral manifestation of diabetes, a necessary ritual of surviving

8 Kisonaite, Agne. "Insulin Syringes Sculpture ‘Diabetes’." Agneart.com. Accessed December 14, 2017. https://agneart.com/projects/portfolio/insulin-syringes-sculpture-diabetes/.9 Ibid.

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the chronic illness, but the accumulative magnitude of insulin treatment. Each insulin needle

represents an injection, an instance in which someone sat down, like the sculpted woman, and

inflicted pain on themselves to survive, a reality Kisonaite literally faces in Image E. The

collection as a whole tells a communal story of type-1 diabetics living their lives. On another

level, the sculpture demonstrates the material impact of diabetes and the accumulation of

discarded material necessary to sustain so many bodies: 5000 syringes, 5000 injection

experiences, and 5000 articles of discarded material.10 They are reclaimed from their designated

material process in order to communicate a reality of malfunctioning bodies.

While Diabetes’ syringes transform into a new art object, Leah Owenby’s series Creepy

Diabetes Art (2017; IMAGE F) shows syringes as syringes, directly addressing the medical

aspect and the contradictions of medical waste in patient experience. Every color in this work is

in contrast; black and white syringes stand alongside orange caps against the teal background.11

The layering of syringes, with an ordered grid of neat lines in the background with a tangled,

eclectic layer of syringes in the foreground, further emphasizes a sense of tension and three-

dimensionality. Contrast of form embodies two significant contradictions of the patient

experience in relation to medical materials. The first is the patient-centric juxtaposition of the

regimented organization of medical treatment—daily injections of insulin—with the chaos of

living with a chronic illness, constantly trying to predict how the body will change.12 A second

juxtaposition is established between the necessity of these medical treatments and the destructive

power of the waste that they create. It is necessary and ethical to provide insulin in an accessible

way for patients to self-administer; it is also an issue that the only way to manage diabetes is by

10 Ibid.11 Owenby, Leah. "My Creepy Diabetes Art." Leahowenby.com. Accessed December 14, 2017. http://www.leahowenby.com/projects/my-creepy-diabetes-art/.12 Owenby, Leah. "My Creepy Diabetes Art." Leahowenby.com. Accessed December 14, 2017. http://www.leahowenby.com/projects/my-creepy-diabetes-art/.

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producing massive amounts of plastic and medical waste. Each syringe represents an instance of

Leah Owenby injecting herself with insulin, but rather than Kisonaite’s syringes, which were

used and represented injections in the past, Owenby’s syringes are unused and lay out a plan for

the future. The chaos and order of this image predicts a structured but uncertain future, one

where there will always be injections, where the illness experience is constant, but where

Owenby will not always peacefully receive it. Owenby and Kisonaite depict the ritual of life with

chronic illness, and by using the tools of ritual, the relics of constant mandatory medical practice,

render that timeline uniquely tangible and quantifiable.

Although experiencing illness can be traumatic, storytelling techniques and the artistry of

medical memory can help patients process their illness experience and cope with chronic medical

involvement. In her book, Inner Journeying Through Art-Journaling (2005), Marianne Hieb

describes the act of creating narrative art as both process and product, continually and

reciprocally.13 That perspective applied to Owenby and Kisonaite’s works, casts the two pieces

as patient narratives and artworks, furthermore engaging with the concept of chronic illness as a

lifelong story. Hieb also includes a full chapter on the benefit of seeing one’s own life

manifested physically, specifically detailing the use of “gazing” and “receptive seeing” as

healing tools.14 By turning personal narrative into visual works, author/artists are meant to view

their own stories with new perspective, as well as be able to share them in a more accessible,

visceral way. The art-journal-turned-fine-art, then, allows a patient to heal from traumatic

experiences while increasing the empathy of a viewing audience.

Beads-of-Courage (BOC), a nonprofit, youth-focused organization, uses visual metaphor

and storytelling as a therapeutic advocacy device for children with chronic illnesses,

13 Hieb, Marianne. 2005. Inner Journeying Through Art-Journaling : Learning to See and Record Your Life as a Work of Art. London: Jessica Kingsley Publishers, p.5214 Ibid, pp. 87-88.

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demonstrating the value of presenting patient narratives as physical, symbolic works. In the BOC

program, children receive specific beads for each medical milestone: black for an injection,

white for a day of chemo, dark green for stem cell harvest, and a yellow bead for each day in the

hospital.15 The results are thousands of strands of beads telling the play-by-play story of a child’s

illness experience, acting both as a standalone representation of that child’s interaction with the

medical world and as an outline from which the child can tell their own story. The strands

become timelines, each bead a metaphor. The beads, however, are still a step removed from the

actual medical experience. Medical waste as artistic, storytelling media removes that step. Where

BOC would use a black bead to represent an insulin injection, Kisonaite and Owenby use the

literal syringes. Modern artists are perfectly positioned to reclaim medical waste for medical

storytelling, combining the viscerality of medical waste with the communicative power of artistic

journaling to weave direct and impactful narratives of disease and treatment. At the same time,

art made from medical waste highlights the issue of waste creation in the first place, which, in

the urgency and necessity of disease treatment, is easily overlooked.

Although artistic reclamation is not a full and reasonable solution to medical waste

accumulation, repurposing waste as art keeps it in the public consciousness and, in causing

public discomfort, highlights issues of proper disposal, safety, and public health. Trash is not a

new issue. There are landfills that have been on fire for years. There are garbage patches that

constantly leach toxic chemicals into the oceans. Medical waste that is not incinerated correctly

—if it is incinerated at all—can shed chemicals into the air and water.16 Even as we create

disposable products to better treat human disease, we can poison ourselves with those same

15 Image of a Kapi'Olani Medical Center patient's Beads of Courage Member's tally sheet. Photograph. Accessed December 15, 2017. https://i.pinimg.com/originals/a5/f6/33/a5f6332f2c8a106a0ca8c9f4c50f6268.jpg.16 World Health Organization. "Health-Care Waste." Who.int. Last modified November 2015. Accessed December 16, 2017. http://www.who.int/mediacentre/factsheets/fs253/en/.

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innovations at the other end of the use process. Essential to Kisonaite’s and Owenby’s works is

the awareness that if not incorporated into the artwork, every element would go into the trash.

While individual artistic efforts are effective for awareness, Toronto nurse Tilda Shalof

has spent 28 years collecting plastic packaging from patient medical treatments, and the mural

she produced demonstrates a more realistic option for large-scale plastic reclamation. Shalof’s 4

by 9 foot mural (Image G) hangs in Toronto General Hospital and contains thousands of caps,

tabs, and other colorful detritus with no hazardous risk, which would have gone straight from

hospital to landfill.17 Each piece of the mural represents a treatment: yellow caps from adrenaline

injections, orange circles from blood culture bottles, and caps from medication to prevent organ

rejection.18 The mural stands as a testament to the beauty of reuse, and the emotive power of

medical objects, which Shalof arranges as literal characters and speech bubbles, similar to

Tironi’s style, to assert the communicative power of waste objects, especially in the medical

context. By using elements from many different patients and many different treatments, Shalof

focuses on trash accumulation, environmentalism and and collective medical experience rather

than on individual patient narratives, distinguishing her work from that of Kisonaite and

Owenby.

Medical-waste-turned-art is not only a therapeutic and environmentally friendly mode of

art marking, but it is a way to convey viscerally the patient experience in a way that literalizes

the accumulation of medical treatments and personal history. Deconstructing the bureaucratic,

structural, and social barriers to patient interaction with the waste produced during treatment is a

step toward wielding that tool. Every time a patient is discharged from a hospital room, that

entire room is cleared. Hazardous and benign materials alike are discarded and reintroduced into 17 Martinko, Katherine. "Toronto Nurse Turns Medical Waste into a Stunning Mural." Treehugger.com. Last modified April 10, 2017. Accessed December 16, 2017. https://www.treehugger.com/culture/toronto-nurse-turns-medical-waste-stunning-mural.html.18 Ibid.

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the environment either as landfill or incinerator smoke. To not only curb those toxic ends, but

explore the growing field of medical waste repurposing and storytelling is the revolutionary

work of patient and medical artists. In adjusting their view of disposable culture, these artists

reclaim discarded narratives of the modern medical world.

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Image Index:

Image A: Tracey Emin, "Tracey Emin ‘My Bed’/JMW Turner," 2017. Turner Contemporary, Margate, Kent.

Image B: Tim Noble and Sue Webster, "Dirty White Trash (With Gulls)," 1998.

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Image C: Dario Tironi, "Ragazzina Seduta," 2016. SimonBart Gallery, Salerno, Italy.

Image D: Agne Kisonaite, "Diabetes," sketch in progress, 2017.

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Image E: Agne Kisonaite, "Diabetes," 2017.

Image F: Leah Owneby, "My Creepy Diabetes Art," 2017.

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Image G: Tilda Shalof, "Talkin Trash," 2017. Toronto General Hospital.

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Works Cited:

"Dario Tironi, Ragazzina Seduta, 2016." Artsy.com. Accessed December 15, 2017.

https://www.artsy.net/artwork/dario-tironi-ragazzina-seduta.

Hieb, Marianne. 2005. Inner Journeying Through Art-Journaling : Learning to See and

Record Your Life as a Work of Art. London: Jessica Kingsley Publishers.

Accessed December 13, 2017. ProQuest Ebook Central.

Image of a Kapi'Olani Medical Center patient's Beads of Courage Member's tally sheet.

Photograph. Accessed December 15, 2017.

https://i.pinimg.com/originals/a5/f6/33/a5f6332f2c8a106a0ca8c9f4c50f6268.jpg.

Kisonaite, Agne. "Insulin Syringes Sculpture ‘Diabetes’." Agneart.com. Accessed

December 14, 2017. https://agneart.com/projects/portfolio/insulin-syringes-

sculpture-diabetes/.

Kuppers, Petra. The Scar of Visibility. Minneapolis, MN: University of Minnesota Press,

2007.

Martinko, Katherine. "Toronto Nurse Turns Medical Waste into a Stunning Mural."

Treehugger.com. Last modified April 10, 2017. Accessed December 16, 2017.

https://www.treehugger.com/culture/toronto-nurse-turns-medical-waste-stunning-

mural.html.

Noble, Tim, and Susan Webster. Dirty White Trash (With Gulls). 1998. Photograph.

Accessed December 15, 2017. http://www.thisismarvelous.com/amazing-shadow-

sculptures-by-tim-noble-and-sue-webster/.

Owenby, Leah. "My Creepy Diabetes Art." Leahowenby.com. Accessed December 14,

2017. http://www.leahowenby.com/projects/my-creepy-diabetes-art/.

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“Rea, Naomi. Naomi Rea to Artnet newsgroup, "“Turner Was a Really Raunchy Man”:

Tracey Emin on Why Her Infamous ‘My Bed’ Is Really like a JMW Turner

Painting," October 13, 2017. Accessed December 15, 2017.

https://news.artnet.com/exhibitions/tracey-emin-bed-margate-1115603.

Whiteley, Gillian. Junk: Art and the Politics of Trash. London, England: I.B. Tauris,

2011.

World Health Organization. "Health-Care Waste." Who.int. Last modified November

2015. Accessed December 16, 2017.

http://www.who.int/mediacentre/factsheets/fs253/en/.