The Art of Surgery

Et toujours! Et jamais! - Pierre Hebert
Et toujours! Et jamais! – Pierre Hebert

There is a subject that runs through the history of painting, sculpture and indeed music, of ‘death and the maiden’, particularly in the Romantic and Symbolist schools, and I suppose I could have called this post ‘death and the surgeon’. My aim, though, is not to highlight death, but rather that interface where art meets surgery. Some surgeons, such as Sir Roy Calne, were pretty accomplished painters, and took their subjects from what they knew. Anatomists such as Vesalius, Bourgeury or the notorious nazi, Pernkopf produced work of great aesthetic merit.

Every now and then though, a work of art grabs me as capturing something special, related to surgery. Photography can do it, like this famous shot.

Most surgeons have been in comparable situations:

Extremely tired country doctor Ernest Ceriani drinks a cup of coffee and smokes a cigarette, in the hospital kitchen at 2 a.m., Kemmling, Colorado, August 1948. He had just performed a caesarean section where both the baby & the mother died following complications. (Photo by W. Eugene Smith/The LIFE Picture Collection)
Extremely tired country doctor Ernest Ceriani drinks a cup of coffee and smokes a cigarette, in the hospital kitchen at 2 a.m., Kemmling, Colorado, August 1948. He had just performed a caesarean section where both the baby & the mother died following complications. (Photo by W. Eugene Smith/The LIFE Picture Collection)

This one caught me today, from @ChickAndTheDead, it’s self explanatory. It might be a piece of upmarket pulp art, but I think it captures something real:


The artist, Saliger, had nazi links, like Pernkopf, does that invalidate what is, to any practising surgeon, a pretty evocative image?

My own practice only occasionally deals with ‘dramatic’ death in the form of life-threatening trauma, although much more commonly in the terminally ill for one reason or another.  Here are two sculptures which capture something unique about that struggle at the interface between death and the chance of continuing to live. I love the fact that the first one is on the side of a hospital

Fulton County Health Services building, Atlanta

The last one is Barba’s sculpture in Poblenou Cemetery, Barcelona, El beso de la muerte and I guess that in the context of this post, the surgeon has lost the battle.

The Kiss of Death, 1930
The Kiss of Death, 1930

This extraordinary work brings to mind a quote I gleaned from the now ubiquitous Henry Marsh, a (sort of) retired neurosurgeon, and a true NHS hero. He references the French surgeon and author, René Leriche:

Every surgeon carries about him a little cemetery, in which from time to time he goes to pray, a cemetery of bitterness and regret, of which he seeks the reason for certain of his failures

When the cars look like insects

Insects of 2014
Insects of 2014

What do you like about America? Assuming that you don’t possess a reflexive hatred of it. Even the noisiest lefty usually has a sneaking regard for the country.

From my point of view, I like the bigness, the friendliness, and the panache of the place. If you were lucky enough to be a white middle class American in the 50’s and early 60’s, life probably didn’t get much better. None of this is to disregard the social issues of those times. The Knife’s second cousin was a civil rights marcher with MLK. But he loved the States.

Lots of things have improved since then – medicine, technology, civil rights etc – but something has probably been lost as well.  The US is coming to the end of its own Blairite experiment, under Obama, and it’s been pretty messy. Like the UK under Blair, a lot of good things have been lost forever. I’ve blogged on this stuff many times before.

Here is Thomas Sowell, one of the greatest thinkers and writers in America, with a vignette of his own. Occasionally the smaller details tell the big story

One more thing. Today as I was hurtling down Portola at the intersection of Country Club Drive I saw a perfectly restored 1956 Ford Fairlane Coupe, two tone, bright yellow and white. It was elegant, powerful, a symbol of a confident nation with an artistic sense to match its power. Now we have little cars that look like insects and we are a nation in as much self-doubt as Barack Obama even though we are incomparably richer than we were in 1956 and there is no more Soviet Union. Where did our confidence go? Somewhere in the deep bosom of ocean buried, chased there by a media that hates the nation and the people that made it rich.

The 1956 Fairlane. He has a point




Public sculpture – where did it all go wrong?

Last night’s World Cup final was great in so many ways, not least the astonishing juxtaposition of Rio’s Cristo Redentor with the sun (and the moon):


It was completed in 1931, funded by local donations, with a total cost of about $250,000, which is the equivalent of $3,300,000 now.  A bargain, if you ask me


Admittedly Corcovado (the mountain) and the bay are unique, but even so, a truly inspiring and aesthetically perfect piece. Here in Britain, if you are on the A1 at Newcastle, you’ll see the Angel of the North, by Antony Gormley. Personally, I like it, though it’s hardly Cristo Redentor.


It was paid for by the Lottery, completed in 1998, cost: £1,000,000. Still good value, and more to the point, enigmatic and impressive.

Which brings me to Arria, the ‘Cumbernauld Mermaid’, on the A80 just north of Glasgow, completed in 2010. If you can imagine a  gigantic Barbie with 4 arms, a 60’s hairband and a fishtail, you’ve got it. The sculptor also did the Kelpies, which are alright, if you have an enormous garden centre to fill, but Arria is just embarrassing. It cost the public £250,000. No doubt the council had a surplus on the council tax that year, and were looking for something to spend it on.

Cumbernauld isn’t really renowned for mermaids, at least to my knowledge. However, if you’re looking for a symbol of money wasting, crazed local government philistines whose taste is in their boots, it’s perfect. I reckon it’ll last about 20years.

I don't know what to say
I don’t know what to say's even tackier at night
…it’s even tackier at night




The W126 Mercedes SEC, again

You can’t have too much of a good thing. The Knifes’s previous two posts on this topic, here and here, have been pretty popular.

I’m no Clarksonoid petrolhead, though I’ve nothing against that kind of stuff, I just love this because it’s so beautiful. It’s also a fantastic car to drive, from the very best Stuttgart era.

On a day when Nick Clegg, not in any shape or form a “man’s man”, decides to blow half a billion pounds of our money on pathetic and pointless electric cars**, The Knife is particularly proud of owning an aesthetically magnificent 5 litre V8 cruiser. As does Clint Eastwood.



**the hospital where The Knife works decided to cut down on travel expenses, although there can be a lot of driving. You could still have the option of an eco-friendly electric hire car (on the taxpayer),  if you booked it in advance. It would certainly get to another hospital 35 miles away, but there was no guarantee that you would make it back. Always pack a toothbrush.

The W126 Mercedes SEC: men of taste and distinction

One of the most popular posts on this blog is an old one, praising the most beautiful car ever made – in fact one of the most aesthetically pleasing objects made by man – the mighty Mercedes 126 coupes from the 80’s and 90’s.

No doubt about it
No doubt about it

Anyway, what brought this reverie on was seeing a celebrity in one the other day. Not just any celebrity, but one with decades of accumulated cool and credibility – Clint Eastwood. Clint was giving his new lady friend a lift.

Clint's white 500 SEC
Clint’s white 500 SEC

Now, why would a multimillionaire be driving around in a 20+ year old car? Because it’s so damn enjoyable. He’s not the only one either. What would the wildest F1 driver of them all drive when he’s not at work?

The legendary Ayrton Senna!
The legendary Ayrton Senna!

And Nigel Mansell, Keke Rosberg and Alain Prost.  Even Martin Brundle.

Or what would the finest living art critic drive (it’s in the superb DVD’s recommended here and here)?

Brian Sewell: my hero
Brian Sewell: my hero
Genius at work
Genius at work







Really, Bruno Sacco is the Michelangelo of modern design. Philippe Starck doesn’t come close. Naturally Bruno drives a 560 SEC. It’s in films and video games.

Sadly, The Knife’s own 560 SEC (see below) has moved on, even if this only a temporary state of affairs.

For unrequited SEC junkies I can recommend this Tumblr page.

Three more images, it’s worth it…

The one in the middle. It's successor is on the left. Still pretty extraordinary.
The one in the middle. It’s successor is on the left. Still pretty extraordinary. jeder Sprache, perfekt
…in jeder Sprache, perfekt




Comic Art (6): Paul Rader

Ever surreptitiously admired a pulp fiction book cover? Seriously, some of these are quite superb.

One of the masters was Paul Rader, who made a bit of money this way. He was also a noted portrait artist, and it’s said that there’s a modern setting crucifixion scene by him in a church in New York State. That would be worth seeing. His Tumblr galleries are quite something, if you like lurid, with considerable imagination and skill.

...another NHS scandal exposed
…another NHS scandal exposed

Design classics (3) – the Omega Marine Chronometer revisited

One of The Knife’s most frequently visited posts is a short piece on the Omega Marine Chronometer, and I’m lucky enough to have got one. Lots of seventies chic geeks and watch nuts seem to be interested.

It's the one on the right
It’s the one on the right

Somewhat amazingly, there’s been a nice one on eBay for a cool £9,750. Not likely in these times

Close relatives
Close relatives

of austerity. Of more interest is essentially the same watch, although geeks might disagree, but in 18K gold. Quite extraordinary, and very rare, and also on eBay for the still painful price (and counting – it’s an auction) of about £5,500**. Not to everyone’s taste, I would accept, but WAY better than the similarly priced new Rolexes, of various kinds. When it gets sold, the pictures should still be available here.


Might have to sell one of the kids.

** Final price £7700, 42 bids. Not bad frankly.

The evolution of uncertainty, about evolution

This is really a straight lift from a highly skilled writer and medical colleague, James Le Fanu. He’s used it more than once, most recently in the Charterhouse column of the Catholic Herald, but it’s no worse for that. The opening paragraph sums up my problem with all this:

The philosopher Thomas Nagel in a memorable phrase laments ‘the ludicrous overuse of evolutionary biology to explain everything about life’ — where there is nothing too sensational, extraordinary or bizarre about the living world that cannot be accounted for as having evolved to be that way over billions of years by the same known materialistic process of natural selection acting on random genetic mutation.

Well, quite.

The most obvious of those ‘puzzling questions’ that he cites is the ‘gene number dilemma’ epitomized by the most astonishing revelation of the Human Genome Project — that we have roughly the same number of genes, a modest 20,000, as the millimeter long worm, C.elegans — that is fashioned from just 1,000 cells (compared to our 60 trillion) in all, has neither a circulatory system nor internal skeleton and a life expectancy of just two weeks. Since then every newly sequenced genome has added its own further twist to this surprising lack of any correspondence between gene numbers and organismic complexity — where flies and chickens, it emerges have a third fewer genes than the diminutive C.elegans while, at the other extreme, plants such as rice and soya bean have twice as many.

The further yet more ‘puzzling question’ is the revelation of the interchangeability of the master or homeotic genes across diverse species, where for example, the same gene that orchestrates the fly’s distinctive compound type eye does so for the very different mammalian camera type eye. That interchangeability across species reaches its apotheosis with the finding that we share 99% of our genes with a mouse. How so trivial a genetic difference can generate such diversity of form defies all explanation, other than to suppose it must be ‘something to do’ with gene regulation, ‘the turning on and off of genes at different times and places in the course of development’.

The implications are clear enough. Biologists could in theory sequence every living creature on the face of the planet, but this would only confirm they all share the same core set of genes that account for the nuts and bolts of the proteins and enzymes of the cell of which all living things are made. But beyond that the really interesting question — that of ‘form’ — what it is that so readily distinguishes the elephant from the octopus, fireflies from foxes would remain as elusive as ever.

These are reasonable points, and as yet, science doesn’t have the answers. It’s not even close.

Come on then, explain us away…

Design classics (2) – the Mercedes W126 coupe

The obvious question here is: why don’t car manufacturers keep the best looking vehicles, just updating the engine, electronics etc as required? The W126 coupes, known as SEC’s, are so beautiful that there is not a single detail that I would change in their external appearance.

...from any angle

Manufactured between 1981 and 1991, not only were they aesthetically near-perfect, they were made from proper steel and industrial strength parts, so if they were looked after, they lasted. The fast ones were really fast – 5.6 litres of fun. No surprise that Ayrton Senna drove one when off duty.

The designer was inevitably an Italian, Bruno Sacco , who himself still drives the mighty 560SEC, his only disappointment with it apparently being the plastic door handle surrounds. I thought they looked alright..

They work too
..what's wrong with the handle?
The great Bruno

Not the subtlest SEC