Body, Medical Humanities, News, Self-portrait without Breasts

‘Attentive Writers’: Healthcare, Authorship, and Authority

A conference hosted by the Medical Humanities Research Centre, School of Critical Studies, University of Glasgow, 23-25 August 2013

Each time I walked between my hotel and the Sir Charles Wilson Building where the conference was held, I passed a sign to Oakfield Avenue. The juxtaposition of disciplines on the sign seemed spot on:

Health Service
Nursing & Healthcare

This was an outstanding conference: a real conversation, or set of conversations. A gathering, a collection. As several speakers pointed out, many more questions were raised than were answered. That seems about right to me, when the subject matter is as complex and important as the roles and limitations of narrative in healing and healthcare.

Many things made this conference excellent. It was beautifully organised (for which thanks again to Megan Coyer, David Shuttleton, Gavin Miller and Elizabeth Reeder); the panels had been programmed with huge care; the keynote lectures were very well placed throughout the whole; speakers and delegates all were friendly, open and generous; two and a half days was precisely the right span. ‘Attentive Writers’ could only have been improved by presenting each of us with a self-cloning kit in our welcome pack – sometimes the difficulty of deciding whether to go to one session or its parallel was quite crippling!

I came away with so much, after so many stimulating conversations. Above all I came home with a renewed faith in how language and creativity can be put to work (and to play) towards healthcare, by writers, health professionals and patients. And this in a rigorous, working-out-in-the-gym kind of way, with a proper emphasis on craft and integrity and with true respect for words and the thoughts and feelings they carry.

It was a humbling and an uplifting conference, all at once. I felt privileged to be there.


Below is the text of the ‘talky’ bit of my presentation. I was part of the panel entitled ‘Beyond Pathography: Varieties of Form in Craft and Care’. Other speakers on that panel were Jac Saorsa: ‘The Argument of Images: narrative diversity in cancer care’ and Izabela Morska: ‘Got Lyme? Here Are Your Metaphors’. The session was chaired by Claire McKechnie. Abstracts can be viewed here.

‘Attentive Writers’: Healthcare, Authorship, and Authority, a Conference hosted by the Medical Humanities Research Centre, School of Critical Studies, University of Glasgow

Friday 23 August to Sunday 25 August 2013

Sat 09.00-10.30 Panel 3b

‘Self-portrait without Breasts: poems by Clare Best and photographs by Laura Stevens’

  1. 3 minutes: show film from Ryerson or via The film was made by Dan Browne and Irene Gammel at MLC, last October.
  2. 7 minutes: Introduction to and summary of the project and its history so far.
  3. 10 minutes: Read poems and show Laura’s images.

2. I’d like to give you an introduction to and summary of the project. After that I’ll read some of the poems and show some of Laura Stevens’ photographs.

The project began a long time ago, as a private process

– It began when I was a girl of sixteen and my mother first had breast cancer. That was when the disease began to affect my life, even though at first I didn’t know what was wrong with my mother: there was only silence. The disease affected my adolescence, my sense of the ‘danger’ of my own growing body, and my early adult years – long periods of which were spent looking after my mother, and being ‘substitute mother figure’ in the family.

– As a patient, my own concerns about the family BC went on over many years of being screened, with all the ups and downs of anxiety, reaching a crescendo as I approached my late 40s, the age my mother was when she first had BC. At this time, my first cousin was also very seriously ill with BC. She was an invaluable adviser throughout my own decision-making period, but sadly died in 2010. This year I have reached the age at which my cousin died. A timely moment to review this creative project in which all the women of my family have silent, invisible, but powerful roles. When we talk about genetic disease, we also recognise something about the continuity of our stories. Our one story.

– As a writer, I wrote as I grappled with decisions in 2005/6. What kind of preventive action to take: continue to wait, watch and be screened, or go for chemical or surgical intervention? What kind of surgery: reconstructive or not, nipples or not? What kind of shape to adopt in public: flat flat or flat with prostheses?

The writing began as journal-keeping: it was preparation, valve, log, a way of measuring movement along the decision chain. Poems only began to come through (and unexpectedly) many months after surgery. Except one: ‘Clear-out’, which I actually wrote long before I was consciously thinking of surgery, unaware of what it was really about, but I was metaphorically shedding my garments, becoming naked.

The first poems to find form after the surgery, were those written out of the hot core of the experience, the surgery itself: ‘Countdown’, ‘I think of love’, ‘Self-portrait without Breasts’. These were urgent, necessary. Writing them was intensely physical, bringing relief and release. Other poems came later, more slowly – those that examine the evolution of change and the re-evaluation of self, and many of these draw on landscape imagery – ‘Self-examination’, ‘Flat Lands’. They took many drafts, they were difficult, reluctant to emerge.

As I built a body of poems, I rebuilt my own body, metaphorically. As I wrote in form, I refound form and shape after losing my previous shape. And I took charge of the narrative of my body. I reclaimed that narrative.

– What about the artwork? Making the casts was a key step in my letting go of my old shape, old self, a few weeks before surgery. The ‘before’ casts now hang on my study wall, alongside some of the ‘after’ casts. Almost seven years beyond the surgery I have virtually ‘forgotten’ or stepped away from the sense of who was the self with breasts. The ‘before’ photos likewise – that woman is another version of me, but so now is the woman in the ‘after’ photos, since even they were taken five years ago. Seeing the ‘before’ casts with my ‘after’ body in the images from the second photo shoot brings together for me the before and after selves, as though they are sisters, or non-identical twins.

From 2008, the work began to go public:

– The first groups of poems were published. I read them in public. These occasions were formative. I was ‘realising’ my transformation. Stepping into my new shoes. But also at the same time generalising my experience: no longer personal/confessional, the poems were becoming the story of a kind of ‘everywoman’. The more I read them in public, the more this happened. I stepped fully into them to present them, I stepped out of them again. The poems were holding the experience, and holding it open for others to inhabit too.

– In 2010, I presented the poems at a life writing conference at Sussex and was invited to submit some for publication in Canadian Woman Studies. I mentioned to the editor I had photos too. The result was publication for the first time of photos alongside poems. That was when I realised the power of the images and the poems together. I came to see the photographs as something more public than I could have imagined.

– Since then I have performed and read the poems alongside the photos in many different settings, including Medical School conferences and Medical Humanities events, across the UK and in Canada and the US.

A few things I have observed as the project has developed:

1. I have been fascinated to observe the ‘stored’ energy that is released as the work has moved along its trajectory from personal to public. It is important to me to honour the connections that are made with this energy.

2. Then there is the value of ‘following where the project leads’ – which is key to the authenticity of this work. To follow as maker where the made thing takes me. The work finds its places. The discussions are relevant to many different discourses: surgery and aesthetics; the medical gaze; gender politics; ethics of genetics; the place of art and literature in patient/physician communications; the study of life narratives; the education of health professionals. I could go on.

3. It feels vital to hold open the space that the poems and photographs create: a place of discussion where everything is allowable, everything is possible. The writer/audience relationship opens into wider dialogues – between medics, patients, care-givers, students, writers and artists. The focus: the reading/hearing and looking at, engagement of the senses with the materials and the maker, seem to free the conversations.

Poems read from ‘Self-portrait without Breasts’ (Excisions, Waterloo Press 2011):

Vital statistics

The surgeon’s album

Two weeks before surgery


I think of love

Breast care nurse

Self-portrait without breasts


Flat lands



Thanks to Laura Stevens for permission to show her photographs.

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