University of Iowa Hospitals and Clinics Medical Museum

Diagnostik

Diagnostik: Blurring the Line Between the Diagrammatic and Emotive Installation.

Marguerite Perret and Bruce Scherting

Obermann Center Symposium
Fleeting Objects: Assessing the Allure of Material Culture
University of Iowa
April 2001

One need not be a chamber to be haunted,
one need not be a house;
the brain has corridors surpassing
material place. 1

Emily Dickinson, as cited in the Diagnostik exhibition brochure.

Diagnostik is a mixed-media art installation by visual artist Marguerite Perret and exhibition designer Bruce Scherting that opened at the University of Iowa Hospital and Clinics (UIHC) Medical Museum in October 2000. Through the medium of art, Diagnostik seeks to provoke contemplation and dialogue concerning the history of mental healthcare in the late 19th and early 20th centuries. Stimulated by the collections of the UIHC Medical Museum, the exhibition combines primary materials, photographs and objects with literary references and original works.

The following exchange is based on conversations that took place between the exhibition principles, Perret and Scherting, about the exhibition development process. Drawn from project meeting notes and recent radio interviews, the dialogue is representative of actual discussions but has been edited and modified for the purposes of brevity and cohesiveness.

Marguerite Perret: While this project was a collaborative effort and we both contributed to all aspects of the installation, responsibility for some components of the exhibition were clearly defined and separate. This division reflects our individual strengths. Let's talk about those different areas.

Bruce Scherting: True, you were primarily involved in researching and developing the conceptual focus of the exhibition and for creating the images, drawn or computer-generated. My contribution was in production, presentation, interpretation and in addressing concerns about audience.

Why don't we start with the impetus for the exhibition? I first met the Director of the University of Iowa Medical Museum, Adrienne Drapkin, through our mutual involvement with the Iowa Collections Coalition. This is a University-wide organization that encourages and advances the professional care, documentation, study and exhibition of the artifacts, specimens, and documents contained in various collections within the University. At some point, Adrienne told me that the Medical Museum was looking for ways to broaden its programming to include art exhibitions related to medical matters. I, of course, immediately thought of your explorations of various scientific themes. I thought the two of you might have some common interests, so I described your artwork to her, suggesting that you two should meet.

Perret: Yes, I have been interested in scientific and medical subjects for many years. Adrienne and I began to talk and meet periodically over the course of about a year. Initially my ideas revolved mostly around producing new works that fit into themes I was already pursuing. But as I became more familiar with the Museum, and talking with you, I started to experiment with ideas that would incorporate materials from the Medical Museum's collection.

Scherting: This, of course, is the starting point for most museum exhibition ideas - the collection.

Perret: But I was looking to do something different. I was not interested in a didactic presentation of the collection: rather, I wanted to use the materials and artifacts to evoke feelings, memories, and ideas. The collection has a history, and each object is like a mnemonic device, it reminds us of something important from the past. I wanted to explore that sense of history and personalize it within an open conceptual framework.

Scherting: How did you begin to think about the various components of the exhibition? Where did the theme of mental illness and treatment come from?

Perret: Originally, the theme was the "museum collections." This, of course, was too broad, and I spent several days familiarizing myself with the contents of the collection, looking for a focus. Initially, I was attracted to the surgical instruments. They are on the one hand elegant forms and on the other hand very threatening. Some of these did become part of the final installation.

During one of my visits, the collection manager was processing the admissions logbooks from the Iowa State Psychopathic Hospital and drew my attention to them. The Psychopathic Hospital was the psychiatric facility associated with the University of Iowa, then State University of Iowa, which opened in the early part of the 20th century and operated until 1991.

I found the logbook entries very compelling, especially the records from the Hospital's early history. At about the same time, I discovered that the museum also has a photo archive of patients and healthcare staff dating back to the 1920s. Based on the conceptual potential of these materials, I started to research the history of mental healthcare and happened upon an interesting coincidence. Hermann Rorschach, the Swiss physician who invented the famous Rorschach inkblot test, first published his research in 1921, the same year that the Iowa State Psychopathic Hospital was opened. I began to think about these two seemingly unrelated events and how they reflected a new emphasis on the scientific approach in diagnosing and treating mental illness. I took copies of these materials with me to an artist's residency program, where I was able to further develop these ideas and explore how they might be visualized.

Scherting: The logbooks are interesting as both objects and as texts. We started to discuss ways of presenting this information and how to use the photographs of patients and healthcare workers that were part of the photographic archive.

Perret: The following are some examples of the logbook entries we have been discussing. These are not case studies, but rather very brief summaries of an individual's history, the problems that brought them to the hospital, diagnosis and suggested treatment.

1927, Patient #604. Lydia M., age 19.
Diagnosis: I.Q. 80
Reason: Illegitimate pregnancy. Factors: First Love Affair, Poor Advice from Mother. Recommendations: Strict supervision because of lack of strict standards.

1923, Patient #283. Catherine M., age 16.
Diagnosis: Hysteria.
Disease and Bad Habits: Undesireable associates, change in conduct, sexual promiscuity, hysterical convulsions, craving for excitement, disobedience, late hours, incorrigibility.

1927, Patient #716. Ida S., age 40.
Diagnosis: Hebephrenic 3
Disease: Over religious, lost interest in home duties, wears hair long and hanging. Admitted for teaching material.

1923, Patient #161. Earl K., age 8.
Diagnosis: ??
Resourcelessness and Gad Habits: Abusive father, death of mother, inability to adjust in foster home, disobedience, negative attitude, excessive demands for attention.

Scherting: I remember when you first shared some of the log entries, how disturbing and yet familiar they seemed. Familiar in the sense that many of the details remind me of people, situations, and feelings I have known growing up in a rural environment.

Perret: Yes, and I think these stories resonate broadly, and not just in the rural environment. Finanacial problems, alcoholism, family conflicts - these problems are as common now as they were then.

Scherting: These logbook entries became am important part of the exhibition and were incorporated into a twenty-three-minute looping digital slide presentation titled "Traces." "Traces" refers to the way this fragmentary information creates a sort of vestigial history of the individual patients, the hospital and the contemporary cultural climate. Accompanying the digital repsentation is the original logbook from the Psychopathic Hospital, from which these entires were derived.

Perret: A sub-text to viewing "Traces" is the idea that you, a friend, a family member, or I could be that person in the hospital. Mental illness crosses all boundaries - age, gender, ethnicity and class. The individual becomes the "other," existing outside "normal" society by virtue of an illness. It is like the story of the changeling, where the original person is replaced by an enchanted facsimile. Our apprehension of the mentally ill is that we can also lose control, change, become ill. That recognition is very powerful and frightening.

But the logbook entries are more than a way to recognize ourselves or embrace our fears; they are interseting indicators of cultural biases. Although mental health professionals at the hospital were progressive in treating mental illness, they were also men and women of their time. On the side of reform, they did not label their patients as "insane," but rather "affected with abnormal mental conditions." 4 This allowed the mentally illto receive treatment without losing their civil rights.

Yet it is also clear that there are many assumptions made about the patients based on social class, gender and ethnic background. Individuals who questioned or stood outside accepted norms for gender roles or sexual orientation were thought to be expressing a psychological dysfunction. Ethnic stereotypes also came into play. A Jewish patient is described as "over solicitous" and a middle-ages Irish woman was labeled a loud, heavy drinker. In a separate manuscript written by one of the Hospital faculty, forced sterilization of the chronically insane is prmoted as a means to stem, "the increasing number of feeble-minded and psychopathic children who grow up to be a burden to society and a diluent to public opinion." 5

Scherting: The slide presentation opens with an excerot from Jane Hillyer's 1930 memoir, "Reluctantly Told." Hillyer's account of her experiences in an East Coast asylum was highly influential, both popularly and in psychiatric literature of the time. The story of the asylum and the personal challenge of mental illness have been the subject of a diverse number of biographies, novels and poems designed to expose, educate, shock and elicit reform.

Perret: Hillyer's account helps establish the empathic tone of the presentation, "By a faint light down the hall, I saw a tall figure reflected in the mirror. It wore a dark negligee, dark hair hung down around a white face, dark eyes looked from under knitted brows. I know that the figure was mad, that I was mad."

Scherting: This is just one of several such accounts in the exhibition. While the Iowa State Psychopathic Hospital remains a central focus, we made an effort to encompass mental healthcare in Iowa, nationally and in Europe in the late 19th and early 20th cneturies. So in addition to the logbooks and photographs, there are personal stories, excerpts from the annual reportsof large asylums, citations from the work of prominent and not-so-prominent psychiatrists, and statements recorded by oral historians. Often the viewpoints presented contrast markedly.

Scherting: Let's talk about how the photographs from the Medical Museum's photo archive are merged into the "Traces" presentation. These are literally images of hospital staff and mental patients interacting, giving and receiving treatment, supervising and participating in activities. We discussed how to use these materials at considerable length. How do we present the logbook entries and photo archives while preserving respect for the subjects? I think it is important to note that although these entries are quite old, the names have been abbreviated to protect the patients' privacy. In my role as an exhibition developer, the use of sensitive materials in the public space or exhibition is always a concern. Photographs, especially of people, have an immediacy that can be quite direct and powerful and sometimes even more problematic than a text. The photograph as a constructed image has been explored extensively, but most people, most of us, still respond directly and uncritically to a photograph.

Within the context of late 19th and early 20th century medical culture, photography was a means to catalog and document. Susan Sontag wrote that photographing people is to "violate them - it turns people into objects that are symbolically possessed." 7 Michel Foucault wrote extensively about perceptions of madness and the institutions of confinement for the sick, insane and criminal where there is a "normalizing gaze, a surveillance that classifies, and differentiates." 8

Perret: I have seen photographs created for this intent, to systemize abnormality, but these particular photographs, from the Iowa State Psychopathic Hospital, are different. These photographs are obviously staged, but the intent is not clear. The scenes are very serene and orderly, patients reading, children playing games, yet you can sense that something is off. An arm hangs limply over a chair, a child holds a toy, but the expression is blank. These are not neighborhood housewives playing bridge or school kids passing a ball.

I was intrigued by this ambiguous quality. I wondered, Why were these photographs taken? To "document" the facility? I found them printed in a 1971 pamphlet celebrating the 50th anniversary of the Psychopathic Hospital 9, but I don't know if they were used in earlier publications. There seems to be a focus on public image - perhaps they were taken to impress donors or state officials.

But I understand what you are getting at - is it exploitive to use these photographs in an art project?

It seems to me that this is a complicated issue. A photograph is a symbolic representation; it is a constructed text that can be interpreted. "The mass of photographs held in archives document us, not other cultures," 10 an idea that I would extend to all groups and populations that have fallen under the institutional gaze. Photography distorts both literally - optically, as light moves through the lens - and associatively. These distortions can be explored and anayzed, and I believe that is a valid avenue of inquiry for a scholar, philosopher or artist. So while certainly photography can be misused to misrepresent, coerce, intrude, those same actions and properties become part of the text to be edconstructed, deciphered, exposed.

I felt that truncating the names in the logbooks was appropriate and that the photographic materials should not be used capriciously. However, prohibiting any use of such photographs would severly limit our ability to explore and understand all kinds of issues. Images can bear witness in a way that a textual description cannot.

Scherting: In addition to the photographs that accompany the slide presentation, you created a series of digital artworks that are based on these same images. The digital manipulation adds another layer of meaning.

Perret: The intent is using these photographs as a source for artwork was to bring some of these same issues to the forefront. There are two stories. Both incorporate the ciricle as a framing device. The circle suggests that the viewer is observing the subjects through a peephole, or the lens of a microscope. It emphasizes and focuses the voyeuristic gaze.

The first series is called "Meditations" and consists of 10 digital prints that capitlize on the symmetry of the mandala (Snaskrit for circle), which Swiss psychiatrist Carl Jung used in drawing therapy. 11 In this context of psychotherapy, the shaping of the mandala is a healing activity. The photographs have been digitally cut, turned, cpoied, pasted, and rotated. The resulting images are kaleidoscopic and intentionally small, colorful and aesthetically appealing. They draw you in, invite you to look closer.

"Blotto," the second set of digital works, is comprised of transparencies displayed as light boxes. The title refers to the children's parlor game on which Rorschach based his inkblot test. Patients, doctors, healthcare staff are revealed or obscured by inkblots in a series of 10 images, the same number used in the Rorschach test. Like inkblots, they suggest figures and contours that are not present in the original source material.

Scherting: Which leads us to the exhibition title.

Perret: "Diagnostik" is drawn from "Psychodiagnostik," Hermann Rorschach's 1921 monograph on the inkblot test. Rorschach died at the age of 37 from complications of appendicitis just one year later. His supporters insist that many of the limitations of the test would have been resolved had Rorschach lived. Nevertheless, since that time, the Rorschach test has become such a controversial and familiar part of both psychological assessment and pop culture. Andy Warhol, originator of much of the mid-twentieth century celebrity iconography, created a series of inkblot paintings in 1984. Rorschach himself was an amateur artist who earned the nickname "kleck," or inkblot, as a schoolboy in response to his constant sketching. 12

Scherting: I was intrigued with your use of the Rorschach test as a metaphor throughout the exhibition to reveal and conceal.

Perret: The Rorschach is a projective test, 13 meaning that patients respond to the ambiguous nature of the inkblot images by projecting their own emotions, inconscious conflicts, desires and fantasies into their interpretation of the image presented. The test administrator can then evaluate a patient's state of mind by scoring the answers against factors such as how common the responses are, whether the subject detects a representation of movement in the image and what areas of the blot the patient focuses on.

By its very nature, the Rorschach test is open to misinterpretation. The patient might not reply truthfully or fully, or the test administrator might project his/her own preconceptions into the diagnosis. This is the basis of the criticism, there is a tendency to over-pathologize or otherwise misrepresent the subject.

The Rorschach test - this ability to expose or obsure - is used as a theme throughout the exhibition. We already talked about the digital works. A related piece takes the form of a mirror cut into an inkblot-like shape that is placed in the exhibition entrance. I think the mirror resonates with Warhol's interest in the inkblot as a captivating void. On the surface of the mirror, the viewer sees his/her own reflection (the gaze cast back) and something else, an images of an open mouth that appears to scream (echo). The mouth is from part of a medical chart installed on the wall opposite the mirror.

A series of drawings based on illustrations from 19th-century medical illustrations exploit the inkblots as windows for viewing the images. The drawings are displayed in specimen boxes. A piece of iridescent material that has been stained by transparent inks is sandwiched between the glass on the lid and the drawing. The refractive properties of the cloth obscure the drawing, except where the ink has been painted. The ink neutralizes the light-diffusing properties of the material so the the image can be viewed.