Previously I wrote about my interest in how we visualise disease within our bodies and that one of my priorities as part of this project was to talk to people for my research who were, or had been, being treated at the Royal Marsden.

I was lucky enough to get the chance to talk to a small number of patients currently undergoing treatment or under observation. I am not recounting any medical detail that we discussed here; obviously I want to maintain the privacy of those who spoke with me. Rather I am reflecting on some of the more abstracted discussions about imagining disease that served as inspiration and provided visual ideas to investigate or develop further. And alongside these reflections are some brief observations about how the London Cancer Hub is experienced for some of those being treated there.

Visualising science

A couple of the patients I spoke to were particularly focused on understanding the science of their experience, although from different perspectives. One had been involved in research professionally, and continued their professional interest. Another was moved to research and understand as much as possible about the scientific mechanisms and processes governing their current experience. Both found the scientific information that they engaged with had an impact on how they imagined their disease. One had a detailed understanding of anatomy and felt that imagination and knowledge were generally in accord, whereas others had an imaginary world that might be influenced by their knowledge, but was not entirely at one with it. 

Visualising cells

In at least one interview, we spoke at some length about visualising cells and about imagining how ‘cells go rogue’. As well as discussing the scientific mechanisms as far as we understood them, more of the conversation was dedicated to how cells might appear in our minds’ eye. One participant described their sense of a small, dark, translucent, hollow globe that represented the cancer cell in their mind’s eye, a cell that was somehow coated in invisibility to the immune system. This contrasted with their vision of healthy cells as a beautiful pink, full of delicate and intricate structures.

Visualising tumours

I asked several of my interviewees whether they had visualised their tumour, or indeed seen images or scans of their tumour and mainly they had not. We discussed how they imagined their tumour within their body. We also discussed the presence or absence of a tumour that you could feel from the outside of your body and the impact that had on your imagination, for example, thinking about the convex and the concave. One person described initially thinking of their tumour as smooth like an egg, but then reassessing after being told that what identified it initially as potentially malignant was that the lump had broken up when excised. 

Because of this, eggs and broken eggs became really interesting metaphors for me that i would like to explore going forward. Eggs are both a site of growth – usually with a positive connotation although not always – and are also often used as an example of extreme fragility. These make powerful ideas to experiment with. I am planning on making a series of eggs and also playing with the japanese idea of kintsugi – the practice of highlighting imperfection through visible mending – alongside such pieces. 

Visualising connections

I spoke to all my interviewees about the London Cancer Hub in terms of any expected or unexpected connections they had experienced through being part of a larger entity than the Royal Marsden itself. Several people mentioned the relationships within the RMH between Chelsea and Sutton. Others discussed referrals from other medical institutions and the relationships between their local hospital and the RMH.

With more than one patient I discussed their experience of using the Maggie’s Centre on the LCH site. They were extremely appreciative of the support they received from Maggie’s, and in particular the patient groups that Maggie’s facilitates which connected them with people who were going through or had gone through similar experiences. 

With one patient in particular we went on to explore the idea of all the connections in a more abstract way. We spoke of bubbles, ripples, radial relationships and concentric circles. They spoke of Boolean searches and intersecting search terms and I replied with Venn diagrams. One of the striking features of the London Cancer Hub is not only the relationships within it but also so many relationships that connect it to other institutions, organisations, groups, both formal and informal. This conversation brought home to me the extent of the network that the LCH sits within.

Visualising ecosystems

We mostly didn’t get on to talking about the comparative ecosystems of cancer and the London Cancer Hub, but there was one exception which I want to record here because I particularly want to come back to it in thinking about sculptural compositions in relation to where this work takes me in the future. This was a conversation where my interviewee observed that one comparison between the two was that cancer was a system characterised by proliferation and spread, whereas the LCH would be characterised instead by unification and concentration. Somehow this had completely escaped me up to that point. It was, and remains, a very useful and potentially productive observation for me to carry into my artwork.

The LCH visiting experience

When I spoke to patients about their experience of being at the LCH as a visitor there was pretty much consensus that their experience was not of the LCH at all, but of the Royal Marsden. Mostly the RMH was the only place they went to on site, but even those who visited Maggie’s were not conscious of any broader idea of collectivity than that Maggie’s was co-sited with the hospital, as Maggie’s Centres generally are.

I asked all the patients i spoke to whether they were aware of other organisations on site. In most cases we immediately got onto conversations about getting lost. More than one patient had become aware of the ICR by entering the site through the ‘wrong’ entrance and getting lost. More than one patient had also got lost trying to navigate the site to find Maggie’s from the RMH. Another had seen the signs for the London Cancer Hub and was confused as to what that was.

It is clearly early days for the LCH and its also true that patients do not necessarily need to know that the hospital they are visiting is part of a larger entity, but it is something for the LCH folk to think about going forward. More than one patient mentioned the benefit of being part of a hospital involved in clinical trials and at the forefront of treatment and the RMH’s alliance with the ICR and other organisations at the LCH might be reassuring or helpful in some other way. 

And more than that, the site is confusing, signage is not sufficient or consistent and people get lost. It was oddly comforting to know that it was not just me. But it points to back to the lack of coherent planning across the site that is currently a feature of the LCH.