the vanity of dogmatizing, publication
the vanity of dogmatizing is a 384 p. large bilingual publication that consists of 22 discussions on the varied understandings of the term science.
The publication was printed in 1999 and is out of stock. The English versions are being uploaded in a weekly rhythm until complete.
Damn it, now some fungus has gotten into it!, Discussion with Gero Gries, artist
The brain is a bloody powerplant!, Discussion with Mats Bigert, Bigert & Bergström, artists
Considerations that take place behind closed doors, Discussion with Dr. Tom Schaberg, infectiologist
Try garden cress, please! Discussion with Wolf Vogler, artist
If everyone makes the same mistake…, Discussion with Dr. Sabine Huber-Schumacher, pathologist
Laments, Dialogues, Litanies, Rhapsodies and Curses, Letter from Morgan O‘Hara, artist
The advocate of the unborn, Discussion with Dr. Wolfgang Henrich, gynecologist
Intro
the vanity of dogmatizing has various beginnings.
Due to my medical and artistic background I was often asked to legitimize my twofold life. Repeatedly, the discussions turned to the fundamental question of what science actually is, and I realised that this term not only had very different connotations, but also had an enormous range of interesting facets. I decided to make use of my experience in both areas and, in the role of the questioner, to locate the origins of the various points of view.
In addition, I came to realize that artists often accused scientists of a dogmatic approach to or concept of science, while scientists could not imagine an artistic relationship to science. It appealed to me to question the fixed patterns of thought, communication barriers and reservations with a publication in which scientific and artistic points of view coexist.
I began to interview people who deal with science on a daily basis in their work and translate this concept into real contexts. In accordance with my own biography, it seemed natural to ask medical professionals or scientists from the medical field and artists or art educators who refer to the concept of science in their work to participate in a conversation.
The conversation prompt, “the current concept of science,” was intentionally broad enough that it could mean anything and nothing. This phrase provided me with the opportunity to engage in conversations that revealed the positions and specific perspectives of the interviewees and thus provided different aspects of the concept of science. The interviewees chose their own topic.
In this way, the generation of the product and the formation of a context remained personal and comprehensible. The views that were brought up add up to an environment outlined from different distances around the topos of the “current concept of science”, which is not focused on, but described at its edges. The descriptions are provided by the participants with their conversations – and thus tell a story of the concept of science – not the story and not just any story, but this specific one, which is composed of the individual conversations in this book.
Bigert & Bergström, Künstler_Birgit Brenner, Künstlerin_Heike Dander, Kuratorin_Dr. Christiane Fricke, Kunstkritikerin_Prof. Erhard Geißler, Biologe und Ethikforscher_Dr. Gero Gries, Künstler_Dr. Jochen Groll, Internist_Elisabeth Gugel, Neurologin_Morgan O’Hara, Künstlerin_Dr. Wolfgang Henrich, Gynäkologe_Peter Henkes, Kurator_Dr. Reinhard Horowski, Hirnforscher_Dr. Sabine Huber-Schumacher, Pathologin_Heidi Niessen, Krankenschwester_Dr. Stephan Oehmen, Anästhesist_Dr. Tom Schaberg, Infektiologe_Eva-Maria Schön, Künstlerin_Dr. Bertolt Stein, Psychologe_Wolf Vogler, Künstler_Susanne Witzgall, Kunstgeschichtlerin_Thomas Wulffen, Kunstkritiker
Tyyne Claudia Pollmann, the vanity of dogmatizing — Gespräche um Wissenschaft mit Künstlern, Kunstvermittlern, Medizinern & Wissenschaftlern/conversations on science with artists, art mediators, physicians & scientists, English/German language , 382 p., b/w, Salon Verlag 1999, ISBN: 3-89770-011-5
Emperor William’s Shot-in-the-Head-Neurology and “Deep Blue”
Discussion with Dr. Reinhard Horowski, brain research scientist
I consider myself to be a brain researcher, that is, I talk about things that I don’t understand and that to a certain extent come up against boundaries by virtue of their very definition. I am a doctor and a pharmacologist, and have been working on animal experiments as well as in hormone research for a long time. I did my doctorate on a cancer-related subject at a Max Planck Institute, and then I tried developing new drugs here within the pharmaceutical industry, using the power and the apparatus that the industry has at its disposal. I was responsible for the first trials of these drugs under the motto of trying them out on oneself. I work in the area of neurological and psychological pharma-ceutics, and am presently mainly involved with Multiple Scle-rosis, outside of otherwise fundamental considerations and ideas. Initially I carried out animal experimentation, with everything that means in a positive as well as in a negative sense. Brain research experiences clear limitations in the animal experiment, just as hormone research and skin research do. That’s why we already attempted to predict with healthy people in which dosage range, with which markers and parameters of effect we could then carry out the clinical studies, because they are quite costly if you want to reach a clear conclusion. In the early stages, we tried them out on ourselves and our test persons in order to gain as much information as possible about our new active substances.
Was that not yet so regimented in those days?
In the Seventies, it wasn’t as regimented as it is today. There is a great tradition in medicine of trying things out on oneself first. There have been many advances, and some victims, too. Just to take an outstanding example: Sertürner tried morphine out on himself and his coworkers and got into some life-threatening situations while doing it. Or Bier at the Charité, who injected both himself and his head doctors with the spinal anaesthesia. Paul Ehrlich’s Salvarsan, the first remedy against Syphilis, was also first investigated for tolerance by the members of the clinic in tests on themselves. Forssmann’s heart catheter led to the Nobel Prize. On the other hand, there were many victims, but my position is that if you want to become famous, and vanity is certainly the motive there, then you should assume the initial risk yourself. Besides, you’ll be able to better understand what position the test person finds themself in if you’ve been in this situation yourself, and, presumably, you have a better hand of cards with the public.
Then you have to believe in the drug beyond doubt.
Yes. I’ve always said, though, that the first trial phase of a drug is really one of the safest phases in drug research. We’ve never had irreversible or otherwise dangerous problems.
But now that’s over with…
Back then, in good years, we had five to seven single active substances or forms of usage for humans. And today, a new active substance for humans comes along every two to three years in our branch, because the developmental expense has become much greater.
Why has the developmental expense become so much greater?
Through the increase in formal demands, an aiming for a higher level of security, and the public’s wish for perfect safety with new medication. Added to this, there’s the increased safeguarding on the part of the officials; the costs, in practice, have not increased in the biological sciences, in the clinic very much, but rather above all in the pharmaceutical area. The officials say: “You can look for even more and even smaller impurities in your substance now, so go and do that and guarantee us that the product will always remain the same.” And that’s where the expense has increased enormously, you have to figure 300 – 400 million in costs for a new drug. All the firms are concentrated now on the most common indications, for example in the area of Alzheimer’s, and other things are being neglected. I consider that to be absurd. Progress comes from small, mobile capital risk firms in the USA who are favored by the law there. That’s the case for rare indications and serious diseases for which a therapy doesn’t yet exist. And there’s a longer protection of a new drug in these cases. For this reason, medication is now coming from the other side of the Atlantic for the first time. That is something that basically experienced a turn-around in the Eighties.
And you’re of the opinion that that’s a result of the increase in cost?
The Americans have that, too, but they were also the first to act against it in the case of rare and serious diseases. That’s not the case here, for example, people with Chorea Huntington, rare neurological diseases which half of all inflicted people die from within four years, could never become the subject of research here. It would have to be researched with pubic funding, and that is very difficult. It is also extremely difficult in the pharma-ceutical industry, however, to get a project going today. There has to be a consensus among many scientific managers. When it is indeed underway, an enormous power is behind it. The strength always lies in the multidisciplinary way of proceeding, where really good experts in different disciplines work together. The problem is in mobilizing this system and in preventing a project from becoming canceled when the first setbacks occur and the fear of the costs getting too high sets in. There will always be setbacks. With us, there’s a meeting of a large amount of research managers twice a year, who then decide which few projects make it through.
And if your proposal doesn’t belong to them?
Then you’re assigned to another project.
Do several scientists work together on a common therapy in one house?
Yes, that the nature of the game, and it’s literally the only way to make anything happen.
And how does the cooperation look?
It’s relatively present. There are rivalries between the American research locations and the European. The Americans tend not to listen to the Europeans. And they are indeed better in many areas, in part due to negligence on the part of the Europeans. Germany is still suffering from the effects of National Socialism. The most impor-tant branches in genetics and in molecular biology were brought to effect by German Jews or leftists who immigrated to the USA.
I just spoke with a geneticist from the former GDR who reported that, in the GDR, genetics was defamed as reactionary and rightist.
Yes. That was connected to the name Lyssenko. Marxism wants to erect a communist society and improve people, and that doesn’t work because human weaknesses are anchored genetically. And so these have to be learned. And the better things which have been learned have to then be able to be passed down, and Lyssenko propagated this and “proved” it with manipulated experiments out of his enthusiasm for Stalin. He was actively involved in the defamation and even outright elimination cam-paigns against molecular biology and genetics. The so-called so-cialist systems failed because of the centralist bureaucracy, because of the paranoia for wanting to control everything cen-trally. They failed because they rejected things that didn’t ideologically fit into their view of the world. Genetics and, above all else, cybernetics belonged to these; cybernetics was also unacceptable, despite Pavlov. And the information technology posed an absolute danger to the extent that it is decentralized by virtue of its structure, difficult to control, and offers the potential to reproduce information at will. A friend of ours from Texas, Abe Liebermann, claims that the socialist societies were still successfully competing up until Sputnik, and it was their re-jection of information technology that led them to fall behind to the point of no longer being able to catch up. That had nothing to do with the justice of socialism as a goal, but much with a centralist bureaucratic control. A mistake which we are currently doing our best to imitate.
You are describing an ideology which prescribes the stopping of science and which, through this, leaves its mark on the whole of society, not only on science. Is our ideology responsible for the concept of science?
Extremely. We only see the things that we expect, on the basis of our education, our structure; whatever doesn’t fit in gets canceled out. And the art or the progress consisted in the fact that dissidents existed that followed these other ideas and, as pioneers, were treated very badly. An example is the Copernican revolution, of course, as well as Giordano Bruno and Galilei; those are the martyrs and saints of the natural sciences. But that existed then as well as now. In brain research, there were phases that were very clearly pointed in the prevailing directions of thinking. Brain research hardly played a role at all, as society was religiously orientated. The immortal soul and how it functioned was the subject, where a person has his knowledge and his self-knowledge from. Then, the Enlightenment emphasized reason to a great degree, to a probably far too great degree, and didn’t know what to do with phenomena such as mental illness. That didn’t fit into the image of the rationally talented human. Brain research from the last century is something I have allowed myself to term Emperor-William-shot-to-the-head-neurology. It was furthered by the weapons technology of the time in that, in the German/French war and also in the Russian/Japanese war, bullets were used that passed through smoothly, leaving behind these punched-out holes in the brain. The neurologists could determine which functions were then missing. At that time, the centers were being taught. There was a center for language, or several centers for language, for writing, for visual perception etc. And these were – and this is where Emperor William comes into the picture – strictly organized into a hierarchy. All the way at the top was the emperor, and he gave orders to the generals, who then gave orders to the officers who, in turn, gave orders to the soldiers – these were the muscles, and then they began marching. Nowadays one thinks that the brain is organized in a decentralized manner, the key word today is network. Chaos theory and quantum mechanics have also penetrated into brain research. The idea is not very original – I read it one year later in Scientific American – but I allowed myself to speak of the “Heisenberg Effect of Brain Research”. That is, a fundamental lack in focus arises as a result of the investigation itself. The object is influenced in its condition to the extent that we can no longer measure or examine or determine it in its original state. That exists in brain research in just the same way. And, for the present, we still have the idea of the network. There’s also, however, been a Darwinist brain research around for about ten years. They say: “Well, brain cells are all somehow the same, swimming around in the brain. Those that make meaningful connections and represent reality the best are rewarded with growth factors and are allowed to go on living. The others die off by selection in the Darwinist sense.” Just as antibodies become optimized through a system of hypermutation and selection, so are the brain connections in the billions and trillions of possible combinations selected in a Darwinist manner: random mutations and selection towards a goal. There is almost no experimental proof for this, but the theory is extremely popular.
Aha, what do you think of this theory, then?
At first, I enjoyed listening to it, and now I am told that there’s little experimental data. I believe that all these theories can take us further, but must not be allowed to be established absolutely with the brain, this system which Sir John Eccles called the true miracle, more miraculous than the universe. For me, it’s also a warning that, influenced by the Zeitgeist, we want to see things that we’re told, things that occur in our environment. We believe that we find them through our research. Another example is what a human is. I just had to think about the Aristotelian anthropology. Man was a two-legged being with an immortal soul. Immortality was an idea. Christianity defined the immortal soul as human and expanded upon that fully. During Enlightenment, Man was a machine. That’s de la Mettrie and the Cartesian picture. I’m taking de la Mettrie now, who at that time was bitterly attacked because he said that Man is just a machine and we can build him ourselves. We’re presently doing that with “Deep Blue” as a chess player. It’s being experimentally investigated when it is that quantity tips over into quality: that’s the question. Later, humans were marked out in the age of a belief in progress, and creation was the non plus ultra in Darwinism. Evolution leads up to Man, even if Darwin didn’t mean it or phrase it in that way. Then, humans were defined through their usage of tools: hence the technical human in the technical age. Humans are humans when they can make a fire, fashion themselves an ax, preferably also slay their neighbor with it, and then roast him on the fire. Cannibalism was contained in the definition during National Socialism. The happy 60’s and 70’s defined humans by their unique sexuality, and were of the opinion that the socialization of sexuality and reproduction was the motor for the greatest developments. That’s a nice theory, that this enormous reward system connected to reproduction was misused by evolution, not only to keep polygamous men with their families, but that these guys also had to try harder and so started making jewelry or bringing home especially juicy wild boar or even writing poems to have a better chance with the women and to more easily propagate their genes than those who still swore by the old power methods.
One tries now to understand the brain as being organized in a decentralized manner. That also stands in the context of the Zeitgeist and information technology.
Damn it, now some fungus has gotten into it!
Discussion with Gero Gries, artist
I think that the discussion between art and science is a relatively one-sided one. It’s only the artists that are producing material concerning the comparison or confrontation between art and science. Science is basically an establishment similar to a modern corporation, in that it has to follow market laws. Art and science once began on a similar level. There was a time when the fine arts were more important than the sciences. If we go back to the Renaissance, when that was all still very close together, we find somebody like Titian, for example. He was a painting baron and became rich at it. In our times, that would be more comparable to a Michael Jackson or a Bruce Willis. What kind of advantage was science able to claim for itself, that its importance in com-parison to art’s could increase to such an extent? Along with its economic usefulness, science has the advantage of being able to work systematically. That means that one can build upon the knowledge of others in science more than in art. It accumulates its knowledge and its experiences, as well. Accordingly, the procedures have become so complicated that one can only work in teams now, which is done with enormous financial support because it’s all very complicated and detailed. One has to be very efficient in these fields. Here, there’s the advantage of progressing with a pragmatic method. Whatever is being researched either works, or it doesn’t. It’s clearly visible. The scientists research for today. They research in order to secure funding for next year or in order to get in a few more publications. I think that their intentions are much more obvious. Scientists make a test series, let’s take genetic technology for an example, where a flounder’s resistance to cold is to be built into a potato. They work for as long as it takes to come up with that using their methods. At some point, they either make it or they give up, either because they haven’t found an alternative, or because their funding has been cut. That’s quite different from how I experience art to be: the lone-wolfing, the outsider status. Art is something like a conscience, it has its value, but it’s difficult to say what that is. Art is more rooted in our magical origins; in this respect, it’s similar to religion. It has lost its usefulness and applicability to a large degree. Scientists have an objective success, they can either demonstrate the cold-resistant potato, or they can’t. Even if that sometimes takes ten years. Fishman, for example, an American, is really big on the medical scene right now because he’s dis-covered a new idea for fighting cancer. The idea is, in end effect, blood supply. It goes like this: tumors only grow when they have access to blood vessels. He thought this up fifteen years ago and also proved it by bringing a tumor cell into the cornea (the tissue covering the eye) of a rabbit. The tumor didn’t grow at first, but tumors emit substances that make blood vessels grow around them. And when the tumor was reached by the small blood vessels, it began to grow. Within a span of fourteen days, its weight increased hundredfold. Fisherman wants to control the growth of tumors through this substance that attracts blood vessels, develop antidotes, and in this way hinder the tumor’s growth. He now has a method for blocking the substances, as well. It worked on mice, and then they ran him through the press on a big scale, so that he doesn’t want to give any interviews anymore. He’s sitting in the laboratory of a children’s hospital in Baltimore.
Oh yes. Cancer research is momentarily stuck in several dead ends. During medical school, I spoke with several German research scientists at Schering about how the situation looks right now, after 15 to 20 years of research and funding that’s been sunk into the most varied projects. Basically, everything was for the birds; now, cancer research is being cut back. They were 50 to 60 year-old researchers that had dedicated their lives to following the trail of viral genesis, for example, and that just didn’t get lucky.
Yes, they work very intensively in medicine. In physiology, there were assistants that worked 70 hours and more a week, just like in the clinic… It’s rough then, when the projects don’t get realized. In science, a series of tests can go to the devil, or sometimes, if chance should will it, new and fundamental discoveries are made. That happens, for instance, through some kind of contamination, that is, through error. For example, the discovery of penicillin by Fleming is such a case. The intention was a different one, and through an impurity, he discovered the medication. A fungus grew by mistake in his petri dish, and then he noticed that the bacteria near this fungus wasn’t growing, that the fungus must be producing something that restricted or killed the bacteria. You can imagine, a fertile ground like that, bacteria are growing, and somewhere a fungus spore falls onto it and he takes a look at it two days later and says, damn it, now some fungus has gotten into it. Then he sees that there’s a halo around it, that the bacteria aren’t growing there. So there must be something in the fungus that’s restricting the growth of the bacteria. But to come back to art: the difference between art and science is that the one is subjective, that is, art has aesthetic perception as its standard, and medicine is objective and has results as its standard.
Objectivity is also an ambiguous term. Objectivity is constantly being overhauled and defined in a different way, it is continually being established that…
The opinion taught that’s often wrong, as is later shown, is mainstream, an inflexible, average institutional research opinion. I mean objectivity as an aim, a criterion that something functions. I don’t know anymore what Fleming was looking for, an anti-biotic? Probably. Well, something, in any case. And at some point, something worked. Then, an antibiotic tablet comes on the table, and you can take it and treat diseases with it. This doesn’t occur in this form in art. There, it’s the case that when two or more people have a profound experience with a picture, then it still remains something subjective, despite all the theorizing and attempts at objectification in contemporary art. If a few people like it, one can’t induce that larger groups will, let alone other peoples.
How is it with objectivity, if one were to take classical examples known worldwide, such as the Mona Lisa or Bach or Mozart… But it’s also, of course, the question of why something has been recognized as a great work of art by so many people.
Mona Lisa, I have to say, is a boring picture to my taste. With Bach, I tend to agree with you more.
I have my problems with objectivity regarding science. Many scientists are aware that they are dealing with temporary approa-ches at all times here, as well. In art, there’s possibly also a certain objective niveau where one can say, O.K., it’s not my thing, but I have to tip my hat, that’s a good work. It’s not only sheer subjective taste according to which one judges.
The fact is that at a certain point in the fame of an artist, a mass suggestive effect sets in that goes beyond good or bad taste, that’s perhaps the objective in art. But the criteria are always something subjective, in that they refer to the subject. That is, an art work is always only an art work through the observing person. There’s always an interaction.That’s the case in science, as well. Since Einstein, Quant and Heisenberg, one knows that basically all experiments influence their results and are experiments by virtue of the very fact that they are being observed. This always has to be taken into account, along with everything else. All standards, all limits, all statements that have any significance are always only made in view of the fact that this is only valid for this one test, for this narrow area. It’s not objective across the board, either.
That’s right, one could work on that theoretically and ask oneself, is there even any difference at all between art and science? This question doesn’t pose itself for me, however, because I know for myself very well that there’s a difference. But where is it, exactly? It’s not so easy to find. Yes, I can follow you there theoretically, but I don’t have to regard the differences according to your criteria, I can’t, in any case. My standpoint is simpler, it’s my own private standpoint. I indulge myself with this in art, I have to indulge myself in it.
You have to in medicine as well, every scientist has to. He or she also has to say: Only for that which I see or know can I make this claim.
It’s just like flying: when you’re up there, in the air, the autopilot is turned on.
Discussion with Dr. Stephan Oehmen, anesthesiologist
I am an anesthesiologist – do I have to translate that? – and so I have to do with the narcosis of humans. Intensive medicine fascinated me already during medical school, because one had access to an incredible amount of technical apparatus. Back then, I was in a large intensive care ward in Bonn, and they always had the state of the art…
Technopark.
– Technology park. During the night shifts, I not only attended to the patients, but got involved with the technology as well, that was really great. In the eighties, a lot of new things came out, especially in medicine, and it was in particular the miniaturization of the processors that enabled this increase in capacity to be brought closer and closer to the patients.
And now you’ve been doing that for fifteen years; you just said a moment ago that a kind of routine has developed over the past fifteen years…
Look, when you’re dealing with advances in medical technology, it’s just like when people are driving a new car: at the beginning it’s exciting, and afterwards it turns into a routine. I assume that’s why cars keep getting bought and manufactured, in order to be sold again. That happens in medicine as well. A new medical technique gets tried out, this and that gets done on the patient, and when all that gradually turns into daily routine, it’s just less exciting. It’s all about game instinct. Why shouldn’t it be the same in medicine? It’s not only the investigative drive and the desire to get to know new pro fes sio nal areas or new possibilities. – Some call it investigative drive, I just call it game instinct.
Did you ever have a kind of moral brake, that you had to stop and think: this is all technically possible, but it doesn’t have anything to do with the patient anymore, this is just pure game instinct…
… a moral brake doesn’t exist in youth. At least that was the case with myself and many other colleagues. To a certain extent, it really is immoral what one does in that case, because the fate of the patient doesn’t get taken into consideration. If people were honest, they’d have to say: “it’s just fun”. But if you’re in the business for a long time – and I do call it a business – you start to think, and then you ask yourself, what in the world were you doing, what do you produce, does it have to be that way -and these days, due to the current political situation, the economic factor is increasingly involved as a parameter.
I once spoke with a specialist in internal medicine who was of the opinion that, nowadays, the opposite is taking place of what occurred in Bismarck’s time: back then, a lot of workers were needed to strengthen the state, and now we have the unemployed; the fewer workers or unemployed there are, the better it is for the state. That is the reason behind the cutbacks. An intervention on the part of the state in the medical establishment now means a reduction of the nor mal population.
I consider that to be exaggerated. What the politicians in end effect force the medical profession to do is make a decision: “Can we still afford to save this patient, who’s sick and maybe no longer useful to society in the obvious sense, or should we park him in some cemetery and say, no, it’s not necessary for him to go on living, he’s just costing money in the end.” That has also been the criticism of the measures taken by the Berlin Charité and several other large hospitals, where scores have been developed that indicate according to which aspects it can be considered highly unlikely that a patient will ever get well again. I find the development of scores to indicate when it’s no longer worth it to continue O.K., not only in light of the present economic resources.
But when you said that that has to do with the economy – if the economy were doing better, you wouldn’t find the scores okay? Would you presume to try to find out those aspects yourself? You’d have to classify the patients.
Yes. We have that anyway in daily life, just as we have it in medicine.
But the difference between that and a score is that a decision is made about a patient without him having the freedom to decide for himself.
You’d be grateful for the honest answer. It would be better than people trying things out on you.
But with a score, a decision is made about you, whether or not you’re allowed to get chemotherapy, for example – and without a score, you can decide for yourself if you want chemotherapy or not.
Fine.
I find that to be an enormous difference. It’s a very tricky thing when doctors decide on the lives of patients. The question is: should the decision remain with the patient or the doctors, and with a score, it’s with the doctors. Whatever the political situation or economic state, it can become more or less extreme, and at some point it could also be said, this is an illness that will no longer be treated any further, do you understand? It gives you the power to select people…
But I find that a great deal of honesty arises with the scores. Emotions would play less of a role and more objective criteria would prevail than if it really depended on the weal and woe of a single medical opinion. The treating doctor could quite possibly be holding onto the patient, keeping him in the clinic and per-forming some sort of meaningless plucking of metastases, and the patient suffers pain – although that certainly doesn’t have to be the case anymore today – and he gets swindled out of the last months of his life. On the other hand, one can never find entirely objective criteria, because every situation is different, and score systems can never encompass every problem. The scores could be utilized such that one could say to the patient: “You know, this is how it looks, it’s not just some opinion, but there are these points that argue for it and those that argue against it”, and then, finally, the personal circumstances should be taken into con-sideration as well, not only the medical and scientific. And then, perhaps, one could let the patient decide for himself.
That would involve more of a humane quality that a doctor would have to have, that he really thinks about the patient’s situation as a human being. And to try to get that into a score…
Yes, this quality inevitably grows out of a youthful game instinct or the desire to try to perform the maximum therapy for a patient. That takes experience, it can’t be taught, everyone has to go through it for themselves, and that’s why I find the scores to at least be a help, in order to be able to say: “Well, you know, in 98 percent of all cases, nothing will work.”
Then do you think that doctors talk enough among themselves about their cases and diagnoses?
That’s where everyone is their own culprit. A lot gets suppressed. We recently had an advanced training in Düsseldorf. There was a specialist in internal medicine there talking about a patient that had a severe case of hypothermia. He resuscitated her for half an hour or longer, but the patient’s pupils were widened, and there wasn’t the least prospect of her ever recovering. Because the hypothermia was so extreme, however, he said to himself: “O.K., I’m just going to keep at it.” And then he drove her under resuscitative conditions to the heart surgery clinic to attach her to the heart-lung machine and restore circulation; I believe she had had a massive pulmonary embolism. Everyone was saying: “What are you doing, there’s absolutely no point to this, the patient has widened pupils the entire time, which didn’t even contract during the resuscitative measures – what’s going on here, anyway!” He brought her despite his own strong personal doubt whether or not he should be doing it into the heart surgery clinic, and there he suddenly saw the patient raise an arm. This confirmed to him that he had been right with the measures he had taken, and he brought her to the heart surgeon. The surgeon rolled his eyes and said: “Come on, what are you bringing me here, can’t you see she’s dead!” But then he went ahead and took out the thrombus – and the patient was released without any neurological deficit. But that’s that one percent, or that 0.000… percent where you have to say, you can never know.
Has a different relationship to your own body developed for you through your work?
No. While I was working in heart surgery for two or three years, I used to smoke and think to myself: “They’re not doing anything other than removing all these calcium deposits in smokers and patching them up again, this really isn’t necessary.” But… you can gladly keep on smoking! I got to thinking when I saw these guys up in the hallway, just before being wheeled into the opera-ting room, smoke one last cigarette, one more time… in the mean-time, there are clinics that no longer operate on smokers. But today, there are also those economic reasons again that play a role; an operation like that brings in a lot of money…
Other than that, on a metaphysical level: how is it when you knock people out, when they lose consciousness… could you describe what the human spirit is for you, or the human soul, or…
No, I can’t. The organ I aim at isn’t the spirit or the soul, the organ is consciousness. The turning off of consciousness and pain. That’s why the spirit and the soul are perhaps something more philosophical, and the whole thing with consciousness more a matter of medicine and science. There was an interesting study a colleague of mine from Munich, Dierck Schwender, did; during narcosis, all sensory organs are turned off except the ear. This is why he performed an experiment, which consisted in playing the story of Robinson Crusoe, with Mr. Freitag and the island and all, to patients during different types of narcosis. Several days after their operation, he asked the patients if they could remember anything. There were different groups of patients, and during one of the narcosis procedures, the patients said that they re-membered a certain Friday (Freitag) or had a dream about some great vacation on an island, or in the case that they couldn’t express something directly, the key word Freitag was named. Some of them then answered:“That makes me think spon-taneously of the story of Robinson Crusoe!” Schwender draws the distinction between two dif fe rent types of consciousness or memory, an explicit and an implicit memory. He also once had a patient that was operated on in the seventies for gall bladder, and later, during various pre-anaesthesia consultations, kept wanting to tell about the experiences he had gone through during his gall bladder operation. This has been psychologically in-vestigated, and it turned out that he wouldn’t have been able to tell the story explicitly, but implicitly something very important must have gone on there. One just doesn’t know exactly what it is that one wants to turn off during the narcosis. One can only say, one tries to turn off consciousness as well as both the explicit and implicit memory functions. I find that to be scientifically interesting. What the soul is, or whatever else there is to say about that…
Spirit or mind…
… I can’t measure that. I can measure an EEG, and that I can keep running during narcosis. I think it’s great that somebody is involved with finding out ways of making things like conscious-ness measurable, whereas one has always been accusing narcosis of the strangest things. And one of the medications that was used then has since been taken off the market.
Ketamine?
No, that’s still O.K. – Thalamonal, this combination of Fentanyl and DHB has since been taken off the market.
Did people get those dissociative conditions?
No. That’s Ketanest. Thalamonal was only given in the pre-medication before narcosis; the patients were injected IM. They laid on the operating table in the corridor or in sterilization and were objectively, for all outside observers, entirely quiet. They could be guided easily, but on the inside they were so nervous and agitated that they would have basically liked to get up and run away. Patients still report this to me even today, that they please do not ever want to have this medication again. I used to use that medication as well back then in Hamburg, but dropped it rather quickly again due to the instability of the patients during narcosis. It became clear that the patients weren’t happy with this pure narcotic procedure consisting only in an analgesic and a neuroleptic, and so a vapor had to be added that makes the patients unconscious. That was, naturally, a horror for the purists of the procedure. They said: “How could you possibly add the vapor! That’s out of the question!” “Well”, I said, “then what should I do when the patient suddenly has blood pressure rates that can be considered to be a direct response to stimuli?” And so sometimes I did it secretly.
What is it like for you, you’re always sitting there at the patient’s head and are mainly watching the monitors…
No. That is, the monitors are or shouldn’t be anything more than an aid. One should never lose sight of the entire picture, whereas today, younger colleagues can’t get by anymore without this kind of aid. I could do it without all of that, as well. One knows, from experience, just about where one lies. Sometimes I read the newspaper, it’s not prohibited, never a daily paper, and I’d like to stress that, but rather our specialized journals. Not every phase is so interesting that one has to stare at the monitor the entire time. At some point the whole thing reaches a relative equilibrium, just like with flying: when you’re up there, in the air, then the autopilot is turned on, and nothing else happens until the plane approaches for landing and starts receiving instructions from the control tower. In the take-off and landing phase, that is, around the beginning and the end of the narcosis, one has to play very close attention. You can’t be involved in anything else. Although the attention paid to the article can never be the same as it would be if one read it at home, that wouldn’t even be possible, and so it’s always a bit mixed.
Are you happy with your job?
What bothers me about my area of specialization is that I don’t stand at the head of the bed; nobody comes to me in the hospital and says: “I’d like you to give me a nice narcosis.” For this reason, I perform a service that has to take care for all hospital depart-ments that the patient gets through the ope ra ti ve situation well. But one is never in the foreground very much.
But you could develop a type of narcosis that would make you so special that everyone would only want your narcosis.
No, that’s nothing for me, that’s paramedicine, and I’m relatively strict about that, I also don’t believe the things I’ve heard about homeopathy or cupuncture during narcosis, and I’ve spent some time with it. But on this point, one has to say that the patients here are completely different than in China, that’s already obvious through the difference in sensitivity to pain alone. For example, a Northern European can withstand an incredible amount of pain, and with a Southern European, you just have to do one little thing and then there’s all this hollering, everything hurts – and the Southeast Asians are exactly like the Northern Europeans, incre-dibly disciplined, and they treat their body in a more in ten si ve way.
With lesser interventions, alternative medicine would be a possi-bility though, for example, at the dentist’s one could so to speak save the drugs and use a needle, and there would be a more mi ni mal intervention into the body…
That little bit of drugs! There is a clear cause and effect relation-ship here, and I know that a person is free from pain. Why should I experiment with some kind of other method whose effects I don’t precisely know? I am very much a purist here. Nothing against natural medicine, but homeopathy is for me not hing but buffoonery. For example, a hot water bottle on the stomach or health teas have a cause and effect relationship, there are certain substances in them that can be proved and measured, and I accept that. But not when I’m supposed to be transporting only the oscillation of some information in a one thousandth dilution. Unfortunately, the classical medical establishment wasn’t paying very close attention, and homeopathy has even gained admission into the medical schools. I don’t understand that. I’m strongly against it, because a lot of nonsense happens along with it. A reasonable discussion would be more effective here. But because so many people need a help of some kind or want to have medicine…
… that’s more of a magical thing…
… then I can just formulate that differently and say, O.K., that’s a lot of fun, and it’s even enough if the information is being transported, which is of course total physical nonsense. But if it helps someone…
… relics, talismans…
… yes, but really. One should try to place it on a scientific level and not go around telling this nonsense, that information is being transported.
You’re always saying “scientific basis”, as though you knew exactly what a scientific basis was. But the history of science demonstrates that the scientific basis, which changes radically every fifty years, what am I saying, every six years medical know-ledge doubles, and the ways of viewing things change. What do you keep wanting to say here? As though the scientific basis were something stable. It’s a construct of our western society, of course: that everything has to be scientific, otherwise it’s utter nonsense.
The Chinese don’t practice homeopathy, for example, but keep practicing their acupuncture and using their herbal teas, which contain some pretty strong stuff. The Chinese can also achieve relative success with their teas. But they can’t heal anything serious with them.
Yes, but neither can we, with our methods.
The brain is a bloody powerplant!
Discussion with Mats Bigert, Bigert & Bergström, artists
B: One or two weeks after Dolly, a 13-year-old boy in America had cloned frogs. They sell biology kits for kids in America for 10 $. Frogs are very easy to clone, because their eggs are so big. But they never really grew up?
P:Oh, yes. The first frogs were cloned 15 years ago. Now with Dolly it was such a revolution because it was a mammal.
B: Nobody really thought that Dr. Frankenstein would show up in a woolen sweater with an Oxford accent!
P: How do you feel about this? Does it frighten you or do you think it’s an interesting possibility?
B: It’s a possibility, but I think it will be morally difficult to use it on people. But of course it is going to happen. All technology and inventions which are revolutionary can be misused and will be misused in one way or another. There will be people who will want to have a little replica of themselves. Just think of it, bringing up yourself. And then let us say, your daughter has a deadly disease and needs a transplant but there is no donor… then they could clone a new kid to use as a spare part box.
P: Or they could clone the organs. That could be something which becomes reality quite soon because it does not shock you so much.
B: You could grow a new heart for yourself, that would be O.K., or a new brain, I would need that!
P:… A question about your art. Sometimes you use scientific connotations…
B: I think the situation of art is getting more and more on the edge of normal life. The borders to other diciplines like science are getting blurred in a very creative way. We often mix scientific topics and ideas with our art on a metaphoric level. Some of our installations, like the Climatic Chambers, you could describe as irrational research, where the visitors are guided through different rooms like mice in a labyrinth, us on the side pulling the switches… This type of project resembles non deterministic science like meteorology where you cannot be 100 percent sure about your forecast. There’s always an element of surprise when your formula is materialized and living matter is introduced to it. Meteorology is so fascinating because it’s a science on the threshold between old, traditional intuition and ultramodern computer simulations. It’s such a trivial science on the one hand, making sure you don’t bump into bad weather on your holiday, but also profoundly abstract in its ways to draw up possible scenarios for climatic catastrophes. It’s like with art where there’s no ultimate truth or final understanding… But meteorology also has formalistic similarities with art. Just look how they try to depict the invisible. It’s so great to look at the weather forecast on the TV and see the symbols they use to represent different movements in the atmosphere. Like the cold and heat fronts for example where the red hot front is a little rounded shape on a red line while cold is a blue one with sharp little nails on it. Just to sit there and imagine the graphic designer who got the comission to design the weather symbols… If we got a commission like that, that would be great! In a way you can see a lot of contemporary art going hand in hand with the development of science and technology, a kind of materialistic siblingship where art is the little brother who’s asking strange questions and using big brother’s toys in the wrong way. I’d like to look at evolution in most fields that way, how mutation and misunderstanding were the most important factors in the process of creating something “new”. But hopefully we’ll see a development in the future when art and science are going to work side by side without discri-mination, especially within branches like computer science and biotechnology…
P: Right, computer-and biotechnology are very vital fields of research. This is also where the money lies or the economy lies; so they are going to be explored in the future.
B: Absolutely, I just thought about some of my colleagues in Sweden who used to hang out in the shitty workshops back in the Art Academy, working with traditional sculpture materials. Now they’re all carrying briefcases and working with computers. This has a huge impact, not only on the art scene, but on software and websites companies who start to hire these artists as creative consultants. We all know about this development, it’s been going on for the last decade, but the importance it will have for art as such in the future is enormous. I think that most modernistic ideals about how to approach and deal with art are going to get swept away in a virtual tidal wave… like the notion of collecting art for instance… that whole physical and fetishistic aspect is going to get transformed into something mental.
P: Does your artistic work affect your feeling for nature?
B: I think so. The first idea for the Climate Chambers was just the physical sensation. It was a concrete question, how the public would react to the different extremes and how they would respond to the art during these uncomfortable conditions, very formalistic. But as the project developed, a lot of other questions popped up. We went to meteorology lectures and started to study all this weird literature from the turn of the century about the climate’s influence on human thoughts. It’s amazing to see how nature and climate were used in such a political way, pseudoscientifically justifying the old colonial thoughts of racial difference. Somehow we knew all this intuitively, but these documents on tests carried out on people, meassuring the mental capacity during different temperatures, gave a whole new dimension to the project. It really became a meta-monument concerning the absurdity of science in all its efforts to simulate being able to prove. So, the naivety that we brought with us from the earlier Biosphere III project dissappered, and instead we found ourselves in a type of hardcore “naturalia-machine”, consuming people as fuel. I have to tell you something about the Biosphere project which is one of our favourites. Before the Climate Chambers we did an installation/performance called the Biosphere III, an enormous piece made of inflated structures. It would take the whole day to describe that one, but it was a comment on this huge utopian project in Arizona called the Biosphere II, where eight scientists were living in a big greenhouse with all the different biotopes from rain forest to burning desert. They tried to recreate Noah’s ark where they would live for two years without taking in anything from the outside. We actually went there and saw it: it was made like Disney World, American style. You paid entrance and had a round tour together with blue-haired women, peeping through the glass at the human guinea pigs.
P: And they are still living there?
B: No, the project went bankrupt and was taken over by Phoenix University which is using the Biosphere for experiments in quite the opposite direction. Now they have converted the sphere into an “atmospheric nightmare” where they launch scenarios for natural disasters. Talk about irony, from the Garden of Eden to a virtual hell of misgrowth and raging pesticides… But this kind of failure is so beautiful and so typical for utopian and scientific projects. I mean, the idea from the beginning is to build a perfect world where everything is nailed to a selfsupporting equilibrium, but as we know, that’s as far as you can get from creating a replica of the world where catastrophes are a highly potent part of the game. But at the start it looked good on paper. I think there was this Russian guy in the 60s, who created a little round glass bowl with mini shrimps and algae living together in perfect harmony. And through photosynthesis it had a cyclic life which would last forever. The Biospherians took this biological “dream sphere” as their raw model when they constructed the glasshouse.The idea of living there for two years came from the time that it takes to go to Mars. Now this idea has been adopted by NASA which has been experimenting the recent years with a much more “sober” version of a selfsupporting cell – the Bioplex Unit. The romantic greenhouse has been transformed into a 7-foot steel chamber with an interior resembling a highway motel, in which they plant a crew of four “chambernauts” who stay there for periods up to nine months. They have to recycle every drop of water and waste to be able to survive, and they grow speed wheat to regenerate the oxygene. And the mental and practical skills celebrated by this crew are more like those of a housewife than the traditional tasks of an astronaut “made of the right stuff”. They are totally determined to go to Mars within the next 20 years. It’s just a matter of money… isn’t it always… hahaha…
P: It’s difficult to pinpoint what actually makes us so fascinated by these type of projects, but somehow these extreme ideas seem to be perfect platforms for us to place our own art. Maybe it’s that they resemble the method of creating art with the aspect of “leaping into the void”, the unknown space where you don’t know if you’re gonna land on your feet or your head. And of course the energy and the determination of these people who sacrifice their lives for science is very inspiring. They kind of radiate this absurd conviction of doing something important, something good… almost similar to the spirit of free religious people.
B: This weird obsession with your work is probably where you find the most similarities between artists and scientists. As individals focusing on one tiny problem that no one in the whole world might solve, spending eons of time in search of the holy lightbulb to pop up over your head. And the satisfaction when it finally does, wow! Imagine when Maxwell came up with his equation that explained how electricity and magnetism were connected, talk about problem solving. I think most of us wait for that moment to come, as the Swedish writer Stig Larsson once explained it, it’s like strolling around and suddenly you’re in this completely unknown space, realizing it’s the final room of the computer game and you made it! I just love these comparisons between software and psyche. It’s so useful to impose all these technological terms on mental processes and vice versa, like the physics of the mind: short circuits, blackouts, flashes of genius… the brain is a bloody power plant!
Considerations that take place behind closed doors
Discussion with Dr. Tom Schaberg, infectiologist
I am a doctor. We concern ourselves here mainly with tumor patients, and the largest part of Berlin’s tuberculosis patients come here.
Is it true that tuberculosis is on the rise?
Not here in Germany. At least that’s the official tenor of the statistics. There’s a statistic of diseases with compulsory registra-tion coming from the Federal Department of Health or from the corresponding former East German institutions that have since been renamed and which have been collecting data on tuber-culosis. And there’s a non-governmental agency in Germany called The German Central Committee for the Fight Against Tuberculosis, which also collects data. These data are based on the fact that doctors report patients. They are required to do this by law, but there’s no way to check. And so one doesn’t exactly know whether the willingness to report on the part of the doctors actually corresponds exactly to the epidemiological picture. There are two forms of tuberculosis: the open, infectious, where the existence of bacteria can be proven. And there are forms of tuberculosis that can be clinically diagnosed without any proof of bacteria. The bacteria can’t be found, either because the right methods aren’t being employed, or because there are so few of them. The patients improve with treatment, however, and so it’s evident that it’s tuberculosis, too. The cases of closed tuber-culosis are reported less frequently. I believe there are about as many cases as two to five years ago, but that they’re just being reported more seldom. Thus, if the amount of reported diseases diminishes by 3 – 5 percent, it doesn’t necessarily represent a genuine decrease. This is indicated by numbers from the new German Federal States, where 80 percent of the reported tuber-culosis cases are open. That’s entirely unrealistic. In all of Ger-many, the amount of open tuberculosis cases reported lies around 50 – 60 percent. It’s incomprehensible why this disease should form an entirely different biological picture in certain regions. In Germany, it appears that we have less tuberculosis each year – whether or not that’s the case is difficult to say. We certainly don’t have an increase in cases. We still have too many patients, however. In the 70’s and 80’s, we thought the disease was receding by 5percent annually and that it would have to reach zero at some point. 12-13,000 newly infected patients are reported de facto each year. And approximately 1,000 die of the disease. Seen in global terms, it looks altogether different. Here, tuberculosis is a serious disease with around 8 million newly inflicted around the world. And the prevalence, that is, the number of people who have an active tuberculosis, is estimated to be around 22 million. So that means 8 million new people are added to that each year, whereas all the others aren’t healthy again yet. So there are 22 million cases of tuberculosis around the world, and around a third of humanity, that’s 1.8 billion, is infected with this pathogen. Either the infected become sick at once, which is seldom and only happens to those lacking a good immune system – Aids patients, for example. The next most frequent case is that they are infected without getting sick, and then, at some much later point, they become inflicted. And the most frequent case is that the infected live with the risk of becoming actively inflicted, but they do not de facto become sick. That is the complicated part of this disease. One doesn’t get infected and then get sick, but rather carries this pathogen around and lives with it. This pathogen doesn’t have any other reservoir than us; it can only exist in the human macrophage. And for this reason it does not, as any little living being that has its own tiny little head wouldn’t, intend to decimate the human race, because it would exterminate its own biological reservoir along with it. Despite that: 8 million newly inflicted and 98 percent of all cases occurring in the non-indus-trialized countries, that is, in the poorest countries of the world. And then the distribution of the disease results in something else, as well. The inflicted are actively sick and have to be treated in order to become well again. If you don’t treat the disease, a third of all patients get well again on their own. All the same. A third remain chronically ill, for years and decades, and a third die, around 3 million. They die because they live in countries that can’t pay for the diagnostics or for the medication. In these countries, the rich have access to medical treatment, of course. For this reason, one can’t say that every person in Kenya or Somalia actually has this fate. Why the disease occurs much more frequently in poor countries can only be explained sociologically, politically and historically. One reason is: where people live together in high concentration, within coughing and otherwise airborne infectious reach of each other, there are, of course, going to be more infections, more illnesses and more deaths. So, point one: high concentration areas are at risk. Point two is: the disease can recede by itself, as well, if the living standard of the population improves. When people are undernourished and badly sheltered, when they are under tremendous social pressure, they lose their equilibrium with the pathogen and are no longer able to live together with it. A classic example are refugees. Whenever a war came along, the First or Second World War, there was always an enormous increase in tuberculosis cases. A few years after the war, that diminished rapidly again. In the former Yugoslavia, there was a relatively low rate of tuberculosis. In areas that were pri-marily spared by the war, not much changed, but in the war areas, the rate was much higher – and among the people that had to flee, the rate is higher than those that stayed home. And so psychosocial stress and strain have an influence on our immune system and disrupt the balance between ourselves and the pathogen. Those are the most important factors. Another factor of more prognostic significance is the HIV infection. The HIV-infected contract tuberculosis more easily. It’s difficult to explain that scienti-fically, but phenomenologically it’s clear; with an HIV infection, all your defense systems break down: The lymphocytes, the monocytes and the macrophages. Those are precisely the cells you need to keep tuberculosis in check. The details are much more complex. The HIV infection demonstrates global differences concerning frequency and occurrence. With us, the rate is relatively constant. In Germany, we have 2,000 newly infected each year. Africa is rapidly on the increase. The largest or the loudest bomb ticking is in Asia, however. There are simply many more people there than in Africa. And, for this reason, an increase in the rate of infection in the population is more alarming because many more people become affected by it. And so 20 percent of all Asians who are infected amount to more people than 50 percent infected Africans. In Africa, the zenith will perhaps soon be reached because of all the poverty. The possibilities for determining how many people are actually infected are, in any case, limited. The HIV test costs money.
Do people go there and check…
Yes. The people there can’t pay for that, the health system can’t either.
… in order to get a larger overview…
Yes. A considerable problem in Africa is that it’s ironically, no, sarcastically, no – cynically the case that the problem is no longer viewed as urgent by the WHO experts, because it’s “taking care of itself”. There will be so many people in Africa dying of full-blown Aids that it’s bound to come to a major decimation of the population. People in their reproductive years are dying, and when every second or more than every second person in a population dies, then there are less children and the population becomes smaller. And then the problem becomes smaller as well. That’s horrible, but that’s how it’s estimated. The experts assume that there will be a considerable decrease in population density in Africa. The affected institutions have already known that for some time. The treatment is unaffordable for the people, un-affordable for the world.
But there isn’t any treatment yet.
Well, now. There has been a lot of progress. And there are optimists who say that that’s moving closer within reach. With great effort, however. The patients have to be treated with many different medications, and high costs are connected with this. Here, a patient with the full-blown disease costs approximately 2,000 DM per month – and this is only for the medication he takes against the virus infection. The prophylactics against other infectious diseases make the whole thing much more expensive. If there are 10 million or 20 million – maybe the number is far higher – HIV-infected people in Africa that have no money, who’s sup-posed to pay? Nobody can do that, even the Federal Treasury of the United States can’t. There isn’t even that much money in the whole world.
Is there a plausible explanation for why HIV has reached such a proportion in Africa? Can it be explained that its source can be found there? There are two types of HIV…
There are several now. The question is, where does this disease come from? A certain type of guenon monkey was the first animal where a virus was found that produces a clinical picture similar to that of HIV. It’s apathogenic for humans, however. It’s a complicated story with viruses. Viruses need us to replicate themselves, that is, they have to have specific mechanisms that recognize humans as humans. And these characteristic structures are probably not that different between humans and apes. Because viruses are small living beings with relatively little genetic in-formation, one can imagine that a mutant developed that was pathogenic for humans. That could be an explanation for why it began in Africa. Could be. A further point is that the ethnic and cultural behavior of the Africans regarding sexuality is quite different than ours. And so there are fewer monogamous relationships. Sexuality isn’t regarded quite so repressively everywhere else as it is in our culture, but is rather much more positively viewed in other cultures. In any case, this is so in Africa. Particularly among many of the different peoples living there. Whether or not there are biological reasons, climate, something…
There is also the theory that it was an intentional laboratory mistake…
Yes, there’s that too. But I believe that’s been pretty well disproved. If that were the case, what point would there be in constructing a pathogen that selectively attacks certain risk groups?
Perhaps that wasn’t so clear at the beginning.
There were some serious discussions whether the US Army hadn’t been researching something with the intention of developing a biological weapon, and that the virus just escaped from the laboratory. That’s all a bit too strange… One could speculate that some right-wing American invented it to exterminate the homo-sexuals in his country, but not the Africans. No, I find that to be senseless speculation. The mutations of pathogens is a biological occurrence which is going on all the time. It is something which can pop up at every cellular division. In the case of viruses, we have no idea how often it actually occurs. Presumably, there will be many new virus infections in the future. The majority of the new infectious diseases come from viruses, and that’s due to the simple fact that we’re constantly developing new methods of detection. The second point is that if the cause were a laboratory error, then why did it only happen once? That’s extremely improbable. Mistakes normally occur repeatedly. There are nuclear power stations that explode, and there were a lot of other serious accidents besides Chernobyl. How can there be one single accident, that would be too strange. There are biological weapons, of course, and they’re being researched heavily. You’d be sick if you knew about all the kinds of biological weapons systems that have already been developed. People looked for whatever was most poisonous, how does this poison work and how can we distribute it most effectively. Not much energy was expended in finding new pathogens, because that’s difficult to check, of course. Even in dictatorships, it’s difficult to test if a new bacillus they’ve developed really kills people off right on the spot. The most you could do is try it out once on a few people in some labor camp. The theory that the virus was created for a biological weapon and then leaked out is something I can’t disprove, nobody can, but there’s neither solid evidence for it, nor are there reasonable indications to assume it to be true. There are clear probabilities that speak against it. But this has distracted us from tuberculosis and the rate of HIV co-infection. Populations in which both diseases occur frequently are especially at risk. Thus, Africa, where there are many HIV-infected and tuberculosis patients. That’s the “deadly mix”, a really bad combination. The prognosis for HIV-infected people is bad, just as the rate is for people who become inflicted with tuberculosis and lack adequate treatment. This could well be politically desirable for certain circles. That someone says: we can’t feed Africa or develop it with so many people, anyway. So a disease that considerably reduces the population is okay with us. One could view that this cynically. That is indeed the case. These are considerations that take place behind closed doors. The problem is Africa at the moment, and it will become Asia next, because the rate of the HIV epidemic in Asia is rapidly on the rise. In some countries, in Malaysia, for instance, when a year of young recruits is tested blindly, you get epidemic rates of 20 percent for the HIV infection. That means that every fifth young man is HIV-positive, and you can imagine how that progresses in a population like that. If you take China and India together, that’s around two-thirds of all humanity. It could be that medical catastrophes such as this are accepted in order to limit the population explosion on earth. On the other hand, there are no realistic possibilities for influencing it. The means you would need do not exist. Where should they come from? Tuberculosis is an inexpensive disease. The entire treatment for tuberculosis costs 35 – 40 dollars, and then the patient is treated over a six-month period of time. That’s the cheapest therapy. It has some very serious side effects, but it works. An expensive therapy is gentler on the body, but it doesn’t have a higher rate of efficacy. In a situation where you have so many people who die so wretchedly, the question of side effects doesn’t play a real role. Let’s say you have 1,000 marks; you’d think about how many people you could heal with that money. Either 20, or only 8 million times 50 dollars, that makes 400 million dollars. That’s what you’d need to treat all new cases each year. That is a sum that can be financed, that’s only a question of creating resources. But the fact is that nothing gets spent on it. It would be feasible, though.
There’s not enough interest, there’s no lobby, it concerns poor people in poor countries…
It’s the poor people in poor countries. And it’s a disease that has a bad image. That adds to the problem. It used to be that tuber-culosis was regarded as something elegant, it was the disease of intellectuals, of artists, of poets. People get so thin, so transparent, they look so ethereal. And when they’re dead, they leave behind these thin, fragile corpses. Today, tuberculosis has a bad image, and I have no explanation for that. There are good, and then there are bad diseases. In America, that’s very apparent: tuberculosis is something embarrassing there in contrast to the HIV infection, which, on the West Coast, I’d almost say has become good form, or at least isn’t burdened by any social resentment whatsoever. HIV is a disease where people get paid attention to. A lot more money is spent on it, too. Now, you ask, why don’t people want to pay the money to fight tuberculosis? Why aren’t infectious diseases interesting? This is the case, really, for all infectious diseases except HIV. That’s difficult to answer. The pharmaceutical industry has an interest in it, because expensive medication can be sold. Maybe it has to do with the fact that the decision makers don’t know the problem so very well. The General Surgeon and the CDC still believed into the eighties that by the year 2000, all relevant infectious diseases would be eliminated, at least in the US. There are wonderful papers from the early seventies from the Center for Disease Control, the American health department so to speak, but a research institution, as well, that concerns itself with diseases and the epidemiology of diseases. This naive belief came from antibiotics. People said, “Now that we have these great antibiotics, we can knock off all the germs for good.” That was the case for tuberculosis, as well. In a 1983 program of the WHO, the World Health Organization, the “eradication of tuberculosis by the year 2000” was declared. This succeeded with some diseases, with smallpox, for example. There were no cases of smallpox any longer anywhere in the world, and the viruses only exist in the laboratory now. With tuberculosis, that’s idiotic, because tuberculosis can exist for decades in the body and still lead to an illness at some point. The worldwide distribution of resources in medicine is peculiar. We spend a lot of money for the research and treatment of tumor diseases in the industrial nations.
But a lot of people die of tumor diseases.
Yes, but it’s overwhelmingly older people who die. The age threshold lies beyond the 60th to the 65th year. One could ask whether there’s a point to making such an effort and, on the other hand, to be spending so little money on infectious diseases that we could heal now, for instance malaria and tuberculosis. If infectious diseases have such good public relations with the HIV patients, then it simply has to do with the fact that the patients are younger. That worries society.
But what about the multi-resistances?
Resistances will occur as long as there are doctors. The moment they undertake something against a bacteria and feed him a poison, the poor animal has to ask itself, what am I going to do now. Either I’m going to die, or else I’ll have to think of something to protect myself. And because the microbes have been around a lot longer than we have, they’ll always think of something. They’re happier and more satisfied. But they’ve been able to adapt themselves splendidly to all kinds of changes this planet has undergone in the course of evolution. Now, there are new procedures to find bacteria. All of a sudden, we’re finding bacteria that have their optimum growth at 100 degrees Celsius, that is, at boiling point. One always assumed that life can’t exist anymore at that point, because that’s when protein congeals. Anyone who drops an egg into a pot sees that. There are infinitely more bacteria than we can imagine. Our fragmentary knowledge of microorganism flora is minimal. And they’ll certainly have an easy time of it with a few ridiculous antibiotics and medications. Resistance is not a moral category, nobody did anything wrong, the doctors didn’t prescribe too much, the pharmaceutical industry didn’t sell too much. That’s nonsense. We just keep running behind the bacteria. And we’ll never be able to win this battle.
That’s basically a Sisyphean struggle.
Exactly. We could, however, accelerate the problem if we make therapeutic mistakes. The patient or the doctor both. With tuber-culosis, it’s usually the patients who make the mistakes. They take the medication prescribed to them irregularly, or they take too small a dosage. Maybe they think, “I’ll stretch the box that’s supposed to last a month out to three.” Or, if they cough, they let their buddy give them a green pill from the box, too. Those are factors on the side of the patients. Doctors can also prescribe in the wrong way. That’s a considerable factor in India. There, most of the tuberculosis medications are prescribed by salesmen and chemists that have no idea about medicine. They have a whole number of boxes of questionable origin and sell this stuff. Either it’s worthless, or they don’t sell it in the right amounts, whatever. It’s a big problem when non-professionals get involved in the therapy, and around four-fifths or nine-tenths of all Indian tuber-culosis patients primarily go to people like that. Then there’s also the problem every now and then that doctors prescribe too much, without necessity or reason. A classical example for this is that in America, a lot of antibiotics are prescribed prophylactically before operations so that the patient doesn’t get an infection. This has been done for decades with incredible zeal; huge amounts of antibiotics are implemented there. It took a long time to realize that infections also don’t occur when nothing is given. O.K. Now take you, just as you’re sitting here before me, you’re from here to around down here a bioreactor containing trillions of bacteria. So, you see, we’re full of them; if we didn’t have them, we’d be dead on the spot. But if you give a lot of people antibiotics prophylactically, something happens within the framework of mutation probability. Now, presumably, there are two types of bacteria, one of which is very rare, the other pre-valent, so-called completely antibiotic-resistant bacteria. In the whole world, there isn’t one single antibiotic that’s effective anymore against these bacteria. And so if you have an infection with these bacteria and can’t cope with it as an organism, then you’ll die of it, and there’s nobody that can treat you. But the larger problem is the employment of antibiotics in animal pro-duction. Most antibiotics are fed to animals. For example, with quinolone, a highly potent modern antibiotic, three quarters of the annual global production goes into the breeding of chickens. If you then eat this chicken, and these bacteria come into close contact with the huge number of bacteria in your intestine, they can, of course, exchange resistance factors. In animal production, there are these wonderful sheets from the industry that read: “How do I breed a cow, how do I breed a pig”, and it’s written there how many milligrams of this and that antibiotic should be added to the food. Now in Germany, there’s been the retraction once of one single antibiotic, which is now prohibited. Whether or not that will have any effect is something nobody knows. If you want to portray the problem, then the animal products industry is 94 percent of the problem. And a half a percent is false consumption and another half a percent is false prescription. Perhaps one should be more self-critical and say that false pre-scription is five percent of the problem.
And the different forms of therapy in different countries…
Shave had very different effects. If you have very little antibiotics at your disposal and are forced to prescribe the same thing all the time, more resistance could possibly arise with certain pathogens. Avoiding resistance means tricking the little guys. And one possibility is that you don’t always give the same thing. That’s what we do here in the clinic, as well. When we have serious infections here in the intensive care, then everybody doesn’t get the same thing. If we did that, then pretty soon everybody would have the same thing, that is, resistant germs.
I read that the amount of tuberculosis cases in Kreuzberg is on the rise due to multiresistant…
The resistance of tuberculosis is entirely man-made, the bacteria aren’t at fault. If you have to take two tablets every day for fourteen days, then presumably you don’t make it. I definitely wouldn’t, I would certainly forget at least one of them, perhaps for an entire day. If you have to take ten tablets every day for six months, then you won’t make that so easily either. That’s the point, that’s where resistance comes from. The second problem is a health system that doesn’t take care of people. In America, Ronald Reagan drastically cut the expenditures in the federal tuberculosis programs of the seventies from 70 million dollars annually for all states down to zero. Which is supposed to mean that tuberculosis no longer exists. And there’s no health in-surance in America. It’s a matter of the cities, the communities and the states to pick that up. This has born results; in Harlem, somebody comes into the hospital with a cough; maybe an x-ray is taken, and they say, “Aha, he’s got tuberculosis”, and then he gets a box of tablets and is told to report to such and such a place. Then he reports there and he’s told that the tablets cost so and so much. Then maybe he goes somewhere else where they give him completely different tablets and say, “Take these first if you don’t have any money.” Resistance can be induced when the treatment isn’t coordinated. You can’t allow people to say, this is my body, I’ll treat it when I please, after all, it’s an epidemic. That someone can do if they lock themselves up somewhere, but as long as they’re still walking around and have contact with other people, one can force them to be treated because they’re endangering other people. If you leave it up to the patients to buy the medicine, it will never work. The treatment against tuberculosis should be free, and for this reason it should also be permitted to be compulsory.
The sash of a Valkyrie transformed into a brutal optical phenomenon?
Susanne Witzgall, art historian and exhibition organizer
Could you first describe what you do and how you came to it?
After my studies in art history, I worked on setting up the Alpine Museum in Munich – a Museum that attempts to write a “history of ideas” of alpinism and to demonstrate the reciprocal effects between alpinism and art, the sciences, philosophy and politics. After the partial opening of this museum, I transferred over to the German Museum in Bonn, which at that time was in the process of being built as well. This museum is a dependency of the German Museum in Munich and is dedicated to the themes of research and technology in Germany after 1945. This museum, too, tries to illuminate a given subject from different angles, bringing to light the interweaving of research and technology with the financial and political sectors. Personalities from very different areas of study have their say in events and publications, such as philosophers and historians. Also, since November 1995, that is, since the opening of the museum, contemporary artists are regularly invited to work on the theme of brain research within the context of the museum and the framework of the exhibition series “Art & Brain”. The works that arise out of this are exhibited for three to four months respectively in a special small room within the collection. Since 1997, I curated the second part of this exhibition series (“Art & Brain II”) – the curator of the first part was Hans Ulrich Obrist. In addition to this, I carry out exhibition projects that are of a purely scientific/technical nature and have been working for around two years on a dissertation about the involvement of contemporary artists with the natural sciences.
You were interested in the subject of art and science at a relatively early stage, already after your studies in art history. How did that come about? Was there an influence coming from within the family, or were you interested in studying something scientific yourself?
If I think of my relatives, there isn’t a scientist in sight far and wide. I did think about studying biology for a short time after high school, though. Then science got the short end of the stick – probably out of the fear that something similar would happen as in Jules Verne’s novel “Le Rayon Vert”, in which a scientist “transforms the sash of a Valkyrie into a brutal optical phenomenon”.
What have your experiences been concerning the contact between artists and scientists? Do you have the impression that the different areas open themselves up to each other, or that a certain ignorance prevails?
My experience has been that both sides are basically open at first for what the other side does. There are fears, sensitivities, reservations, or even a lack of knowledge, however, which make communication difficult. I don’t know, though, if one should speak of ignorance here. Some art historians, a specialist for medieval glass painting, for instance, can be more ignorant in his attitude toward a contemporary work of art than a scientist. The scientist understands perhaps very little about current art, but certain themes an artist is involved with are possibly closer to him. An artist often approaches a scientist to gain professional advice or certain material for the realization of his or her idea and will search for the specialist corresponding to his or her theme. In this way, based on an interest in the same subject, a bridge arises between the artist and the scientist. The two might approach their respective contents in entirely contrary ways, but the subject offers them each a point of reference for their ex-change. Of course, the opposite can also be the case, although, according to my experience, this is quite rare: A scientist looks at a work by an artist and recognizes analogies to his or her own work or feels inspired by the artistic work. Perhaps he or she approaches the artist and suggests a cooperation. I believe, how-ever, that a true exchange only functions through an interest in similar content. Bringing together Jeff Koons with Stephen Hawking would probably be very difficult – but who knows?
Is there a crossover between the disciplines, or is it more of a marginal appearance that artists involve themselves with the natural sciences or vice-versa?
There are many contemporary artists that are involved with scientific themes. The same can’t be said for scientists, though. Scientists are professionally involved primarily with their own specialized scientific research, and not with art. This is not a point of criticism. Whatever they do in their free time is, of course, another matter. With the whole discussion on the relationship between art and science, it’s important to first define what we’re talking about. Are we talking about a long-term collaboration and an actual coming together of artists and scientists, or are we talking about artists working with scientific subjects? An example for the first case exists in the area of artificial life research, where computer artists are working together with computer and natural scientists. Here, the boundaries between the disciplines are more fluid. One recognizes this when artists who, among other things, are involved with the conditions for artificial life, such as Karl Sims or Sommerer and Mignonneau, publish their work to a certain extent in scientific papers, or when a percentage of artists can always be found at conferences on artificial life. The second case is certainly more widespread in the contemporary art scene, however, and this is more one-sided than the first. According to my opinion, here it’s more about a reflective process on the part of the artists, who can assume very critical positions in regard to science. Many artistic works, for example, have the ethical, philosophical, or social aspects of the results of scientific research as their subject, or they undermine the scientific picture of the world. That doesn’t mean, however, that such artists don’t seek contact with scientists, or work together with them temporarily.
The working title of your dissertation is: “The Natural Sciences in the Art of the Nineties”. Are artists of the nineties more involved with science? Do you see this as a phenomenon of our present time?
When one takes a look at the history of art up until now, there were always artists in different times who were involved with scientific themes. Leonardo da Vinci – who is frequently abused in this respect – was an artist and a natural researcher, William Turner was interested in, among other things, geology, George Seurat was inspired by the scientific studies of the British scientist James Clerk Maxwell and the American Ogden Rood, Kandinsky was fascinated by the new discoveries in atomic physics, and Robert Smithson was involved with entropy and the laws of thermodynamics, to name only a few examples among many. It becomes obvious, however, that there weren’t artists in every epoch or in every decade – at least not very many – that involved themselves with scientific content. Certain waves of interest appear to exist. One such wave can be detected at the end of the sixties and the beginning of the seventies, and another appears to have taken hold of the nineties. And in this respect it’s possible, if you wish, to speak of a phenomenon of today’s time.
Is it possible to distinguish the type of involvement present in the nineties, in contrast with the sixties and the seventies?
The art of the sixties and the seventies and the art of the nineties are different from each other in their relation to science, firstly in that different scientific theories have been seminal for each. Many artists of the sixties and seventies, for example, got in-volved with system theory, which since the forties had become widespread not only in science, but also in sociology, information theory or even in economics. An example for this is Ludwig von Bertalanffys’ biological systems doctrine, which, among other things, is founded on the basic presumption that the organism is to be understood as an “open system”. Today, the system theory only plays a subordinate role in computer art. On the other hand, the artists of the nineties do not enlist their knowledge in botany, zoology or genetics for the purpose of aligning their artistic work with a certain scientific theory. They often call the scientific methods and models into question. What connects today’s time, however, with back then is the fact that contacts between artists and scientists are being made and cooperation is taking place. In the sixties and at the beginning of the seventies, there were special establishments, such as the organization “Experiments in Art and Technology” (E.A.T.), called into being in 1967 by Billy Klüver and Robert Rauschenberg, and the “Interdisciplinary Center for Advanced Visual Studies” (CAVS), founded by György Kepes the same year, which brought about and furthered the collaboration between scientists and artists. The fact that artists and scientists realize projects together, or that scientists support artists in the realization of their work, is no special feature of the nineties alone.
I am a biologist. Perhaps I should also say that I was undecided in 1950 as to whether I should study biology or journalism. So, I first worked for a half a year on a newspaper editorial staff. In the GDR in those days, one had to go through the philosophy department to study journalism. I listened to a few lectures by Ernst Bloch, and that disturbed and shocked me: I didn’t understand a thing, not a single thing. I discovered that this course of study did not come into question for me. And so, I studied biology – with the aim of becoming a popular science author. My father had all the Cosmos volumes on his bookshelf, books by Bölsche, Bürgel… they made a big impression on me. Father wanted to study, but couldn’t, because his father was a goldsmith and couldn’t afford to send his son to college. In 1953, I accidentally found out that there was an Institute for Microbiology here in Berlin-Buch. And so, I came here, did my practical training here, but wound up in the Institute for Cancer Research. That was pure coincidence: the microbiologists had no laboratory room for me. One of the many happy accidents that have determined my life’s path. Here I noticed for the first time all that could be done in the field that was just as exciting and important as popular science writing. In those days, the tumor clinic was already in existence. And the combination between the laboratory experiment and the fact that a few meters away, people were suffering and often dying from a terrible disease whose cause could be researched was something that fascinated me greatly. The academic institutes in Buch were a relatively small establishment in those days. The entire staff would have fit in a river boat. We all worked a lot, into the night and often on the weekend as well. And we had a lot of parties together with the doctors and nurses – there was a large supply of unmarried nurses, and that was tempting, of course… First, I worked in radiation biology, for the diploma as well as for the dissertation. After the doctorate, I went into genetics in 1960 because it was an exciting area that was still entirely under-developed in the GDR. In the Soviet Union, there was an effective moratorium on genetics in place since 1948, and that naturally went for the satellite states as well, for the most part. Genetics had the reputation in the East for being a reactionary science.
What was the reason for that?
There were even arguments against it that were entirely rational. The physicists Max Delbrück and Karl Zimmer, together with the Russian geneticist Timofeeff-Ressovsky, who was active here in Buch, wrote a work in the thirties on the nature of genetic mutation and the nature of the gene. That stimulated Erwin Schrödinger, winner of the Nobel Prize for physics, to think about the secrets of life. And in his book, “What is Life”, Schrödinger wonders about how, for example, the tiny gene of the Habsburg lip managed to be passed on unchanged for centuries. He dedicated an entire chapter to this question under the heading,“Delbrück’s Model”. Delbrück, who was in fact actually a theoretical physicist, then worked for Lise Meitner. The collaboration with the Buch geneticist Timofeeff led him to investigate whether there were special physical laws in biology that only applied to life. And, at the same time, an entirely new approach to the investigation of the metabolism became possible through the discovery and exploitation of the stable isotope. There were these crazy calculations back then: a dog is an entirely new dog within 14 days or so. It was proven that nothing stays the same, that a restructuring of all components of a living body is constantly taking place. And then there were the genetic scientists with their thesis that hereditary traits remain stable and unchangeable for centuries. For this reason, genetics was denounced as a “bourgeois” science in the Soviet Union, for it propagated immutability and therefore didn’t agree with the principles of materialist dialectics that everything was supposed to operate according to. One of them had to be wrong: the geneticists or the Marxists. And because Marxism was true, then the geneticists had to be wrong… I’m a little proud that I was apparently, after having been invited to hold a lecture in 1978 at the Düsseldorf World Congress on Philosophy a quarter of a century later, the first who was able to resolve this obvious contradiction. There is a quite trivial explanation: it’s not the genes, the hereditary material, that are stable, but rather the genetic information itself. But, in a time that equated genetics with heresy, the scientific foundations were still lacking for this insight. A second argument against classical genetics, which they denounced as “reactionary”, was that geneticists worked pre-dominantly with fruit flies, drosophila, and didn’t worry about ameliorating the widespread shortage of food again prevailing in post-war Soviet Union. Nikolai Dubinin, for example, a well-known Soviet geneticist, was accused of having had nothing better to do, even during the “Great Fatherland War”, than count flies’ legs… and after the war, when the food shortage catastrophe broke out, the agrobiologist Trofim Lyssenko, who enjoyed Stalin’s favor, posed the question: “Where is genetic science’s contribution towards ensuring nutrition?” The worst was that the harsh criticism of genetics was brutally executed. The institute was shut down, teaching was prohibited, and the geneticists were sent into the desert. And this was precisely at the time of the stormy development of molecular biology and molecular genetics. In 1944, DNA was discovered as a transforming principle, in 1952 came the proof that DNA was the decisive component in bacteria viruses, the bacterio-phage. And, in 1953 came Watson and Crick’s structural elucidation of hereditary material. During this time, the entire socialist system had effectively locked itself out of all research in molecular biology. Up until the deciphering of the genetic code in 1961, genetics was for the most part prohibited; this had repercussions for decades, above all for public education, and there weren’t any books to be had on the subject, either. So, in 1960 I entered the Genetic Department of the Institute for Cancer Research. My boss back then and a friend today, Arnold Graffi, was the nestor of cancer research in the GDR and saw to it that I, who throughout my studies had never heard a single lecture on genetics, was able to go to the Genetic Institute in Cologne for a quarter of a year. Max Delbrück was at that time in the process of building it up to be the most important teaching and research institute for genetics in Germany. There, I was able to hear the foundation lectures of Carsten Bresch and perform laboratory experiments on the transference of genes in bacteria under Peter Starlinger, tests that were to be decisive for my further work over the following decades. When I came back from Cologne, the last geneticist that was here at the Institute was just leaving for the West and left me alone with an assistant, with an ancient washing woman who had already washed out Timofeeff’s laboratory glasses, with a handyman, and with 120 strains of Drosophila that still stemmed from the time Timofeeff carried out his famous work in Berlin-Buch. I had actually only studied bacterial genetics in Cologne and had no knowledge of Drosophila, and so in the Winter semester of 1960/61 I went to West Berlin to take part in a Drosophila course at the Institute for Genetics at the Free University. That was relatively unproblematic, as it still was before the building of the Berlin Wall. After that I was at least in a position to think up halfway intelligent experiments for my colleagues to carry out with the fruit flies. I, however, worked with bacteria and bacteria viruses, wrote a little book about bacteriophage genetics and held lectures on molecular genetics at the Humboldt University. Then, in 1962-63, it was decided in the Soviet Union that genetics and molecular biology are indeed important and should be taught as well. As was customary up until Gorbachov’s time, all corresponding Soviet decisions were implemented in the GDR. And so, it was decided upon in the GDR that genetic science should be developed once again, and that it should above all else be taught, too. But there were only, in effect, a handful of geneticists. And this too was a great fortune for me: because I had at this time already done my post-doctoral research on microbe genetics and had experience teaching, I was called to the University of Rostock in 1965, although I was not only relatively young, but also no longer a party member. In Rostock, I held lectures on genetics, microbiology, virology, and bacteriology. And I built up a small “Institute for Microbe Genetics” with a group of dedicated young scientists. At the end of the sixties, reforms were carried out in the academic and university areas, and the research landscape was reorganized. In the midst of all this, it was discovered that there weren’t any groups in the GDR that were involved with the genetics of animal cells. On the other hand, the Rostock biologists were urged to concentrate on fishery and marine biology from that point on. Which we didn’t feel like doing. I still had the paradisiacal times here in Buch in memory, and I proposed that we should move from Rostock to Buch and set up a department for cellular genetics there (out of which the virology department later developed). That meant a lot of negotiating and doesn’t correspond to the image that many have of research planning in the GDR. When we came here, I took all my scientific colleagues from Rostock with me. Our job was called “cellular genetics”, and we were supposed to propose what we wanted to do. They left that entirely up to us. We then read a lot and had discussions and traveled around the socialist camp. Visits from Western institutes were at that time unfortunately no longer possible, in part due to the fact that I had just managed to successfully elude a recruitment attempt on the part of the Stasi (Staatssicherheit: East German Secret Police). Before that, while based in Rostock, I was able to get around quite a bit, and was able to follow up on an invitation by the “Mecca of Molecular Biologists”, the Cold Spring Harbor Laboratory on Long Island. That was so extra-ordinary that it was even depicted in a DEFA film, “Life with Uwe”, for which the Rostock writer Siegfried Pitschmann, a friend of ours, wrote the script and which Lothar Warnecke directed. Among others, Cox Habbema, Eberhard Esche, Rolf Hoppe and Dieter Mann were involved. I was supposed to play myself – which my old boss Graffi, however, urgently advised me against doing: it would ruin my last bit of respectability. And so, I was played by Friedo Solter, but that didn’t work out so well. After intensive preparations, we worked on a theme package and submitted five proposals for research programs. One proposal was to develop haploid mammalian cells, that is, cells with only one set of chromosomes. These would be well-suited for genetic research. That was turned down as being entirely unrealistic, and perhaps it really was unrealistic. Another proposal was to work on the palette of propositions for prenatal diagnosis using cellular genetic methods, that is, to develop methods of already recognizing further serious hereditary diseases in the unborn. That was too practically oriented for the directors of the academy and the advisory committee before whom we had to defend our proposals. Our daring proposal to work on Interferon was also rejected. Interferon was too mystical for our directors, which was very unfortunate. What was accepted was our no less daring idea of developing a system of genetic transfer in animal cells which could perhaps one day be a model for genetic therapy. We battled around with this for quite a few years, under unfavorable working conditions – until we discovered that American groups enjoying incomparably better conditions were involved with practically the identical program. Then we were able, with the approval of the Academy’s directors, to terminate all plans in the immediate present, the near and distant future – even that was possible! – and concentrate on the possible role certain viruses play in the development of human brain tumors. Our fifth proposal for a research program at the beginning of the seventies, by the way, was to try to carry out the transplantation of nuclei into mammalian egg cells and to use this for the animal industry. That is, something similar to cloning. We sat down together with the Berlin domestic animal geneticist Schönmuth and worked out a cost-benefit calculation, for example, for high-achievement cows or horses conceived in this way. Although we considered that to be very promising, it too was rejected as being too practically oriented.
That reminds me of Dolly…
Yes, Dolly. We were carrying on the “Dolly Discussion” in the GDR already since 1970, when we began every two years in the Baltic Sea resort Kühlungsborn to discuss the chances and risks of modern biological sciences in interdisciplinary colloquia – with the inclusion of artists and writers. Since that time, I have been trying to make it clear to people that it is complete idiocy to go crazy over the dangers of human cloning. The human counter-part to Dolly are identical twins. Actually, they’re much more than Dolly, because identical twins not only have identical genetic information, but grow in the same womb at the same time under the same conditions. And despite this, even identical twins are different individuals! So, I’m talking about the fact that many people today again or even still believe what the big guru Hans Jonas already wrote back then: that one can now reproduce Hitlers or Stalins or Marilyn Monroes or Mother Teresas at will. This is all nonsense, that people with the same genetic material are identical. Human condition and behavior, the essence of human beings, is – among other things, but not exclusively – determined by genes. Even with identical twins, there are, of course, differences. They usually, but not always, look very similar, yet they are entirely different individuals indeed. And if people have the notion now that they want to manufacture their deceased child anew, then it will be an entirely different child. It might have similar genetic traits, but it will develop after a respective time delay and under very different conditions. It will be a sibling child, nothing more and nothing less. And that’s something that can be brought about in the customary way, involving much less risk and an increase in pleasure, besides. When I was called to Rostock, the discussion was just getting underway about the dangers of genetic engineering and the responsibility of the geneticists. There was this famous/infamous conference in London called “Man and His Future”. There, in 1962, the cloning of human beings was discussed for the first time. Somebody had already cloned frogs by then.
This cloning had already taken place at the beginning of the sixties, or even earlier. I was invited in 1966 to a lecture in Geneva (that was my first trip to the West after the building of the Berlin Wall), and there, in the Zoological Institute by Professor Fischbach, I saw a terrarium in the cellar that contained hundreds of apparently completely identical frogs. With an intestinal cell, so to speak, for a great grandmother. And back then in the late sixties, it was already being discussed everywhere on both sides of the Iron Curtain, and hence in the Soviet Union as well, whether one couldn’t employ cloning methods in order to improve the human race – for example, to reproduce Shostakovitch or the important physicist Lew Landau. That was being seriously discussed. The American writer Ira Levin, author of “Rosemary’s Baby”, knew much more than the philosopher and moralist Hans Jonas. In the mid-seventies, he described how the concentration camp doctor Mengele cloned Hitler in his novel “The Boys of Brazil”.
Hmmm.
Successfully at first. In Wolfsschanze, Mengele removed bone marrow cells from Hitler’s body. Then, after the war, their nuclei were implanted into egg cells in South America, and 48 Hitler clones were carried through to the full pregnancy term by young consenting indigenous women. After birth, the clone babies were given up for adoption – with the help of an agency in New York where an SS doctor worked, played by Flickenschild in the film version – to unsuspecting parents seeking to adopt. These had been previously filtered out very carefully by the group for their similarity in every conceivable respect to Hitler’s actual parents (the film is unfortunately not even nearly as good as the book). But the whole thing became exposed because inexplicable murders suddenly began occurring in Central Europe and America, which initially didn’t seem to have anything to do with each other. Then it turned out that all the victims were men in their mid-forties with a son 13 years of age. And that all these sons have blue eyes. And they all either play the violin or paint in watercolors. Only one breaks the mold and wants to become a director, with Hitchcock as his example. The fathers were all killed by the cloning group of the underground SS, because Hitler’s father died at this age and the Hitler clones are supposed to experience exactly the same thing. And…
But now we’re talking the whole time about these…
Now, please, let me finish at least. I believe that it was Simon Wiesenthal who found out in Ira Levin’s book that the SS is committing the murders because Hitler is supposed to be reproduced successfully. He didn’t get any support from the FBI or the CIA to prevent further murders from being committed by the SS because they thought it was all just a bunch of baloney. Then he’s supported by a Jewish combat group, and when the SS unit is brought to a standstill in a blood bath, the leader of this group asks: So, now, where’s the list with the Hitler clones? Now we’ve got to kill them all, too. And Wiesenthal takes the list and swallows it and says: You’re not going to get this list. These are all thirteen-year-old boys. They might have the same genetic material as Adolf Hitler, but it’s not written anywhere that even one of them will develop into a criminal of this kind… No, one really doesn’t need to be afraid of cloning, or of “people breeding” either, for that matter. Even widespread fears of this kind can be traced back above all to the previously mentioned London conference of 1962. It took place at the same time as the Sputnik shock, and for this reason the important British scholar Haldane discussed whether one couldn’t transplant genes of gibbons or wide-nosed apes into human genetic material in order to better adapt humans to the conditions of space travel. This absurd idea traveled around the whole world. What didn’t get around was the fact that Haldane had relativized his idea to a great degree: he expressed the opinion that this would certainly not become possible within the next 1,000 years. And the heading of his article read: “Human Genetics in the Next 10,000 Years”. Haldane’s remarks and other speculations expressed at the conference were received especially sensitively by us in the GDR. They unleashed the question in the press: where do the actual differences lie between the modern genetic engineers and the Nazi geneticists? That’s where we entered the discussion. And then we came to the conclusion in the mid-sixties that one didn’t need to have an inordinate amount of fear of cloning and people breeding. Of course, there are possibilities everywhere for the criminal abuse of science and technology. That is normally limited to single individuals. And it’s not a specific trait of genetics and geneticists.
You said that you had stopped the experiments on genetic transfer in your department and had returned to cancer research. Why did you then turn away from that and address your attention to biological weapons?
In the previously mentioned discussion on the dangers of genetics and the responsibility of scientists, I had already run into the subject of biological weapons. The really big danger of an abuse of genetics and microbiology, one which wouldn’t only affect individuals, but would operate on a global scale, is military abuse. I had been following this consistently since the late sixties out of the corner of my eye and had lectured and published on it occasionally. I entered into it more intensively when the Stockholm International Peace Research Institute (SIPRI) asked me in 1983 to write an article on “Genetic Technology and Biological Warfare” for their renowned yearbook. Then, in 1986, I published my first book on the subject of biological weapons, with conclusions that were in part completely contrary to the official political policy of the Warsaw Pact States. For example, in it we demanded verification, that is, controls for the compliance with the B-Weapons Convention. That was a taboo subject in those days. Yet the book didn’t appear in the GDR, but rather with Oxford University Press. Despite this, I’m amazed even today that this and my other scientific political publications, including those on the subject of disarmament, were never subjected to censorship – except for one manuscript, in which we attempted to disprove Jakob Segal’s assertions, according to whom the Aids virus was constructed by genetic engineers on the US Army payroll.
Were you also afraid that biological weapons would become deployed?
Yes. I was and am very worried indeed, above all because through the developments in genetics and in other areas of molecular biotechnologies, a new and dangerous potential has accumulated. Very respected colleagues from the United States regard this as being dangerous. Others have classified me as crazy. And others again as an Eastern Block propagandist; I just heard now at the last Pugwash Convention from an Englishman: We thought back then (in 1986), when you came out with your book, if somebody from the East publishes that, then he’s got to know a lot more than he’s writing, then he must be setting up a smoke screen to veil the activities in the East in this field. Exactly the opposite can be found in the Stasi files. There it reads: Professor Geißler holds an entirely different opinion than the Foreign Ministry does. And despite this, they let me express it. Something like this doesn’t fit into the typical GDR picture, but one naturally can’t generalize on it. The Foreign Ministry insisted, however, that all concrete proposals should be eliminated in a statement I wrote in 1986 on behalf of the medical and biology classes at the Academy of Sciences, which called for measures to strengthen the B-Weapons Convention. The opinion of the responsible GDR officials and of the Warsaw Pact States in general was, at least until the Fall of 1986: The B-Weapons Convention has existed since 1972. The Convention prohibits the development, manufacture, and storage of biological weaponry. And that takes care of the problem. In my Stasi documents, it’s written in respect to this: The Foreign Ministry is satisfied with the B-Weapons convention, and Geißler demands change. We won’t stand for that, for if the convention were to be changed, then our enemies would be able to assert things we don’t want.
You wanted to change the Convention? Did you want to make it stricter?
I wanted to make the Convention stricter.
Because you had the suspicion that, with the new genetic possibilities, one could…
… But that’s not only a suspicion, Iraq has demonstrated just that. In the few years leading up to their defeat in the Gulf War, The Iraqis had produced at least 19,000 liters of concentrated Botulinum toxin, which is by far more poisonous than the most dangerous of the chemical warfare substances, and more than 84,000 liters of concentrated anthrax bacteria, which belong to the most dangerous biological weapons. And UNSCOM, the UN- mission controlling Iraqi disarmament and rearmament according to the Security Council’s decision, has been traveling (at the time of this discussion) for more than five years throughout Iraq, turning over every second grain of sand, and they’re still looking for 16 rockets whose warheads contain anthrax bacteria munition. Iraq was a signing party to the B-Weapons Convention. Hussein was at least morally bound to abide by the contract. After his defeat, he was forced to formally ratify the convention, as well. The solemn signing of the treaty took place in Moscow, because Russia is, as successor state to the Soviet Union, one of the three depositary countries containing the original documents of the convention agreed upon in 1972. Despite this, Yeltsin had to admit in 1992 that the Soviet Union and Russia had been breaking the convention for the past twenty years and had been taking offensive preparatory measures towards biological warfare. I was shocked back then: as a kind of “true believer”, I had believed in the Soviets’ dedication to the convention. Even in the Spring of 1989, I defended them vehemently on a four-week lecture trip throughout the USA against corresponding accusations. You see, the Americans had had the suspicion since 1979, at the very latest, that the Soviets were developing further biological weaponry. They assumed that a huge anthrax epidemic in Sverdlovsk – today Ekaterinburg – could be traced back to an accident in a B-Weapons factory. Although that has, in the meantime, been proven with a probability bordering on certainty, not least thanks to the persistent research of my important colleague Matthew Meselson, one of the pioneers of molecular biology, the official Russian departments to this day continue to deny this and assert that the epidemic was caused by meat from the black market that hadn’t been sent through inspection. But the Americans didn’t have any proof to back their claim before Yeltsin’s confession. In 1986, a hearing led by Senator Edward Kennedy took place in Washington. Kennedy asked why they didn’t go to the Security Council. There, they’d be able to submit the corresponding breaches in contract. But the representatives of the CIA said they didn’t have the hard facts… But even if there had been proof for the Soviets’ breach in contract against the convention already back then, the Soviet Union could have vetoed it as a permanent member of the Council. But at least the whole affair would have been made public. That’s not all just yesterday’s news, unfortunately. Even today, the suspicion has been expressed that the Russians continue to work in this area, and there are still justifiable concerns as to whether or not Hussein has really given up his B-weapons program. The way in which he leads the Americans around by the nose leads me to suspect the worst. Although I can’t always understand the Americans’ reaction, either. And then there is the increasing threat of biological terrorism. We know of the Japanese Aum sect – which carried out the poisonous gas attack in the Tokyo subway – that they also worked with anthrax and botulinum toxin. I am very unhappy about the fact that, according to my impression, this threat of biological terrorism is not being taken very seriously, and that in Germany, of all places.
How does that work with the ethics committees in Germany – it’s questionable whether they actually function.
As you just said: If you’re a member yourself, you can veto it, and then it never comes to an investigation. Can research even be investigated?
In the final analysis, I don’t believe so. I was one of the founding members of our ethics committee here in Buch. There was a certain order to it. When, for example, a proposal was submitted by a research group that had a member in the ethics committee, then that member wasn’t allowed to vote. Naturally, a proposal can be formulated in a number of different ways. The patient’s declaration of agreement plays a big role, but, according to my experiences from that time, it seldom goes so far that a committee checks out afterwards whether or not the formula submitted now is the same as the one used then. The majority of sponsors require the vote of the ethics committee for tests involving investigations on people: otherwise, there’s no money. When something un-foreseeable nonetheless happens – which can, of course, occur, despite a positive decision on the part of the ethics committee – , then whether or not the committee approved plays a role. Then, the leader of the test is absolved of all personal responsibility. For the affected patient, that’s no real solace. In addition to this, the ethics committee is only responsible to a very limited degree when a submitted project is financed through Institute funding or otherwise by a third party, for example by the German Research Community (DFG) and their advisors.
That brings the Herrmann case to mind…
That was one of the people they used to point to, to show how one can work effectively scientifically. Professor Friedhelm Herrmann was someone you could measure yourself against. He had an impressive list of excellent publications, all in very important journals. To put it in a mean way: For us lame “Easties”, he was the exemplary “Wessie” par excellence. In the meantime, it has emerged that a whole number of his publications were quite clearly forged. This came to light – if not at an astonishingly late point in time – because one of the doctoral candidates got up the courage to confide in a mentor from the outside. There must have been extraordinary conditions prevailing in the collective, otherwise it never could have remained unnoticed for such a long time.
How is your collective?
In 1987, I left my chair as head of the department of Virology and concerned myself exclusively with biological armament control. Up until the founding of the Max Delbrück Center, I was a one-man “peace research collective base”. I’ve had a doctor colleague for the past few years who’s being financed by sponsoring money that the DFG has made available. He’s working on possibilities for the conversion of former Soviet B-weapons institutes. And then there’s another doctoral candidate who’s investigating measures for increasing faith in the B-Weapons Convention – and, unfortunately, their only very limited efficacy. For the moment, however, we have to get along without her, because she’s working at the UN in Geneva as a freelance member of a group of scientific experts which is momentarily producing an additional protocol on the B-Weapons Convention (and with this, realizing my old ideas). And I’m paid by the Volkswagen Foundation. We also have additional budget funding that the Institute makes available. The three of us have not only been involved in disarmament but have also worked in the ethics committee of the Institute. And occasionally we hold seminars on the ethical problems of the biological sciences.
Is it possible that your function is to play the ethical conscience here on campus? The suspicion arises when one sees the list of research projects.
There’s still someone around for biologically ethical research. We were already here before the other projects gradually became established.
You were here from the very beginning. But first you directed virology.
Yes, at the Institute for Molecular Biology. But even then, we didn’t lock ourselves up in an ivory tower. Since 1970 we’ve been trying, not least with the Kühlungsborn colloquia – which, happily, it was possible to save through the reunification – and together with our closer specialized colleagues, as well as with other scientists, doctors, humanists and artists, to discuss philosophical and ethical themes pertaining to biological science. Both Professor Ganten, the Scientific Director of the Institute, and the Administrative Director of the Board, Dr. Jost, found it reasonable and correct that questions such as these were being thought about in a center for molecular medicine. They have been supporting us from the very beginning.
The stomach in the thigh
Discussion with Birgit Brenner, artist
I’ve been involved with the theme of the body for two years. I find it really horrible when you have to stay in the studio all the time with the work, which is already stupid enough on its own. This type of work lets me go out, though. So I had the opportunity through a friend’s father, for example, who’s a medical examiner, to watch him at work. I also go to the library a lot. I’ve read about various subjects relating to the body, about murder and death by accident and forensic science, and naturally about medicine and organ transplantation and on through various bodily perceptions, for example with schizophrenics, who I’ve always found interes-ting because they have a different language due to their illness, very flowery, you can really use it. With schizophrenics, their bodily perception changes too, they usually feel very shredded or torn up, like if the stomach didn’t digest in the belly but in the thigh. I found this change in perception, that the body’s no longer working inside, to be an interesting aspect: it’s working all the time, but we don’t really notice it. You have to get sick to register your body again. I also discovered a statistic about the weights of women’s internal organs in a medical book, and I made a few pieces on it. Yeah, that’s the nice part about the work, that I can get out and watch other things going on.
That you have contact to another world besides the artistic?
Yes. You’ve got to somehow fill the whole thing up and that’s what I found so hard with painting, because I had the feeling that it didn’t matter what I was going through, what I was living – it all gets reflected so differently, not directly, like I can do now. You could push that further. It’s really in right now just to document something. But that’s something I never wanted to do. That’s where I’m still a little old-fashioned in terms of what art is.
What do you mean, that one just documents?
Well, that was never my thing. I want to make something of my own. I’m not interested in just giving back what I’ve seen. “That exists, I’m showing it” – I don’t find that to be enough. I’d have the feeling that I was using and exploiting other people’s illnesses, their fates. But I’m a total dinosaur in this respect. I usually begin my search in the key word index in the library. I look until I discover a concept that interests me. It’s like with a pyramid. And then for weeks I keep asking myself: “What does that have to do with you? Why are you reading that stuff?” I’d just like to find out which part has to do with me. At some point, the subject gets more concrete. And that’s how the objects arise that I sometimes show together with reading material and statistics.
And so you acquire the information mainly through reading?
My husband comes from the area near Eickelborn. And one of the largest forensic clinics in Germany is there. From sex offenders to alcohol and drug withdrawal. Most of the area’s inhabitants work there.
Does he, too?
He doesn’t, but his father worked there. I’ve gotten some information through him and his former colleagues. It’s hard to get into the clinic. I didn’t even want to. They’re doing bad enough, I didn’t want to use them for my work. I discovered a book on forensic medicine, and it described every kind of accident: a body that had been run over by a train, or somebody that had been burned. Those are deformations that make it hard to imagine how anybody could take seeing that. It’s enough for me to see these realities in the form of book illustrations. The idea that that could be somebody that you know or love – they just aren’t even bodies anymore.
I ask myself, as well, how one could do this job…
A lot of them drink.
Yes, how they can stand it, I never understood that.
Above all, what kind of attitude they have to their own bodies and to death. My girlfriend’s father only inspects the contents of stomachs. He’s actually a chemist and only wound up in pathology by chance. He avoids – whenever possible – contact with the autopsy room. I had developed the work pretty far before I went. And what I was able to see there was the inspection table after an autopsy. There was some blood and there were some glass jars with organs inside. They remove the stomach to determine the last food consumed, and the liver to detect poisoning, and some blood. And I thought: well, that’s it, that’s what’s left. The way it stood there, it was really abstract. All in all, I found it pretty impressive.
To see how these things are in reality.
Yeah.
That’s why I’m asking. I studied medicine, and I was in pathology and forensic medicine, too. This mixture of Tupperware and corpse was very peculiar; that they spoon the lung fluid out with a ladle, like in a kitchen, and keep human organs in refrigerators. And on top of that, the atmosphere and the smell and all. I wouldn’t be able to make an art anymore that capitalized on that, and that’s why I think that it’s better if one really gets to see it all than if one just reads about it.
If you really work there, that all changes, as well. The only experience that I can lay claim to is a year with handicapped children and youths, and, what really did it, three months with kids impaired by environmental influences. Compared to that, the handicapped live in a protected world.
Kids impaired by environmental influences and abused children. I did that too, yes.
That’s fifteen years ago now. I didn’t really get it then, but now I do – that there were a lot of sexually abused children among them. A friend of mine works in psychiatry, and from him I learn about things out of his practice, and he gives me tips for reading. I do try to look to the praxis, but I also try to bring about this change: I have to let it go through me, something besides reality has to come out of it. At least, that’s my intention and my interest. – Up until now, I’ve always worked with books first to get a direction, until I have a structure. Parallel to that I go to the studio, of course. It’s not only about reading. It’s reading and working and reading and working. It goes hand in hand, the head parallel to the hands – that never works with me in the beginning. In the studio, I really only make sketches for myself. That’s my way of thinking about something that I’ve read, and at some point, it all starts to come together, thank God. It never works at the same time, though. I’m usually around two months behind what I’ve read and seen. When I get more concrete with a subject, then I get moving – for example, there’s this trauma institute in Freiburg, in which people with traumata like that of Eschedde or Rammstein are treated – but without any information about it, a visit wouldn’t do me any good, because you don’t see anything at all. The interesting part is what goes on in your mind. Without any prior information, it doesn’t bring anything. Where I defi-nitely want to go, though, is the sanatorium for artists. That’s where those people wind up that have suffered a reality shock, that is, when the creative energy runs out and they think: “Shit, I didn’t make it into the world of art and I don’t have any kind of social security, what have I done with my life…” And then some of them experience such an awakening that they actually crack up. There’s everything there: literary people, singers, actors, artists.
Try garden cress, please.
Discussion with Wolf Vogler, artist
I’m someone who’s operating within the intersection of art, science and epistemology. I come from painting, originally. I also studied art history and philosophy. For this reason, I’m familiar with science, at least with the humanistic sciences. The natural sciences have interested me since 1989, and quite centrally in one particular field of my work. My question then was: “What activities point far into the future in this discipline neighboring art?” I found them in physics. I began my studies by investigating things in the recent history of modern physics – from Einstein’s theory of relativity onwards – that go far beyond our imaginative capacity. The origin of the project was that I realized in 1989 that we can reach a point in art where we arrive at new definitions or concepts and then at new methods if we work on the concept of reality. Along the way, we might come up with another concept of art as a result. The initial hypothesis, then, was the work on the concept of reality. It must be, it should be, it can be explored and then formulated anew. The thesis is that there is a knowledge of reality implicit in the work of art. If we attempt to bring about a fusion, a synthesis, a bringing together again of art, science and epistemology, for example in the work and person of the artist, if we attempt that, then we can experiment with different methods in the process of propagating knowledge of reality. In 1989, the first instance was the idea of a research into the fundaments of art, which I termed “art research laboratories”. I suppose there must be studios where what I mean by this research into the fundaments of art is already being carried on. I imagine their connection as being purely virtual, ideal: the “art research laboratories, assoc.” If we’re already working with scientific concepts, then it should be done in the global scientific language, which used to be Latin and is now English. Then, I had brass plates made for these imaginary art laboratories, and set out on my search to find out where this was already happening. But I saw very little. Many beginnings, hardly anything that came to the point. With me, as well, everything was still in the beginning stages. I realized that it was still too early for this idea. It is indeed difficult to fulfill an expectation of this kind through concrete formulations using objects. Then there was the job with the cultural department head in Wiesbaden to write a concept for a symposium on new possibilities for an art festival in the nineties. The study I wrote was entitled “What’s art doing – in the mean-time?” It was clear to me that the present epoch was a historical transitional situation, a time of a “Copernican Transition”.
Are you under the impression that we’re living in a transitional situation?
Yes, my archive is bursting at the seams already, there is that much proof for this evaluation. I can’t even keep track anymore of all the areas where it’s being conjured up. The evolutionary process of consciousness presently underway is a force to be reckoned with. The decisive question is: what are the phenomena that attest to it? What does that mean for me personally in my artistic work? In 1990, in the above-mentioned study, I said, let’s just let this festival form a “sculpture” for 10 years, a new kind of institute for the research into the fundaments of art. Everybody thought that was a great idea, but we were very far from being able to actually install something like this. Then it became clear to me that it first had to take on a form in my studio. That’s how the project for ten tables developed, entitled: “momentarily not to be seen”. On ten simple wooden tables, I investigated, purely through contemplation, the most varied phenomena of reality as described by science in classical form. Contemplation means viewing together. Contemplating the reality described by physics is indeed a way of attaining to another knowledge of reality. Through this, I came to the further instance “New Physics”. The “Plant Film” demonstrates that the artist no longer imagines by means of a vision, a fiction, or a utopian idea through the classic media such as sculpture, computer or painting. The initial impulse for the experiments with the energy contained in a grain of seed was a sentence I read around a hundred years ago in some science-fiction novel: “They moved on rippling carpets of plants”. While observing the ten tables, it can happen that everyday reality slips out of its normality for fractions of a second.
You founded New Physics in 1994. Is that an institute?
Yes, but only a virtual one.
How is it when you read scientific articles on the newer physics?
It’s a lot of work.
It must be an incredibly specialized language.
I can only say that physics is a discipline that has departed earth with its ideas. That is, the level of abstraction is so high that one can say it lies beyond the capacity to understand and to imagine of all persons not highly specialized as well.
So you read it and can’t really understand it. Can you imagine something despite this?
Yes, due to the continuity of my involvement with the material. Otherwise, I’d have to pass.
But you couldn’t be sure that an article isn’t total nonsense?
No. That would be too glib. The question is whether or not there are possibilities for me to comprehend what is being researched in science right now. I can’t comprehend that through the linear/discursive or through the rational, it works rather with the help of intuitive comprehension. Contemporaneity means that in this context of understanding another discipline, I’m operating within the same mental cognitive space as the scientists are. The question is only whether I can see through these cryptic formulations. I can understand the statement about a phenomenon as it’s des-cribed in the medium of language or in a formula. That works when you’ve already worked through a few fundamental concepts of Einstein’s or Heisenberg’s, when you approximately know what physics is actually trying to describe with its super string theory, for example. What’s important to me as an artist, though, is how avant-garde, surreal and crazy is physics today? And there I can say: it’s absolutely fantastical. It no longer has anything to do with reality whatsoever. Then I think back and ask myself how it is with us. What is it like in my discipline, in art? In genetic laboratories, 30,000 year-old bacteria are being revived, and in the studios, they’re reviving styles in art that are twenty years old. I enter into the dialogue with my own discipline, the critical analysis of it, discerningly, but also with irony and humor. I have come to the conclusion – which turns out to be a classic one – that this direction in art is momentarily still in the phase of language and theory. It is the conceptual formation of new and different abstract concepts. Since 1994, I myself have been involved in New Physics with how I can get something out of the working hypothesis, out of the conceptual formulation of theory and into the first concrete objects. I’ve realized that it’s going to require a period of time that’s still unforeseeable for me.
Have you ever had the idea of becoming a physicist?
No. Because I’m an artist in body and soul. I need the adventure of the discovery, however, of a vision or of a utopia. Art is for me always that which I can’t yet do. I need a working hypothesis that still lies in the future, but one in the process of developing a lasting power of attraction. I wouldn’t want to transfer over to the field of science, because I’m interested in fusion. It is said that they were once unified, a beautiful idea. Was that really the case? There are enough experts that say they formed a unity which then later diversified. Synthesis once again belongs to the future. I can imagine, I know how it could be. To bring it about is another matter entirely. In answer to your question, though, no, I don’t want to transfer over to physics. As a project, it would be too large.
Have you worked together with physicists?
Worked together would be saying too much. We were at DESY, where they’ve already reached the other side of matter. These particles they find in their big detectors don’t actually exist. They can only be measured in terms of their reciprocal effects. You don’t see them. My aim is also to formulate a knowledge of reality in the artistic practice that refers to this zone of reality which is no longer material or physical. At DESY, there were huge tunnels and halls, and we had great conversations. Otherwise, in my encounters with scientists, it doesn’t go beyond a very inspiring exchange of thoughts. The idea of the interdisciplinary is one I don’t follow. What’s crystallized for me is that this “inter-” still doesn’t possess a gesture or a congenial form. That is, the working results either slip over into art, if it’s supposed to be interdis-ciplinary, or into science.
With your work, it slips over into art.
Obviously. The concept of the transdisciplinary is my working concept, that is, moving through one’s own discipline to find another form of synthesis. The physicists have these electron scan microscopes that position artificial configurations of indi-vidual atoms. In the meantime, there’s an even more progressive form in which individual atoms are not only being made visible for the first time, but can also be taken and placed in a configu-ration. That was at the end of the 80’s, the beginning of the 90’s. First, they spelled out “IBM” with tungsten atoms, and then they made a world map. In California, they’re already doing much more complex things. They’re beginning to form artifacts without value or meaning out of individual atoms. That’s exciting. Is there going to be an art form in the future beyond the nano-level? A highly fascinating matter. Where is the truly new form, and how will it look? Can we then say that it’s no longer interdisciplinary, but rather transdisciplinary from both sides? A nuclear fusion, where one can say, that’s no longer art, that’s no longer science, it’s not epistemology, but it’s a true synthesis. This is the field I’m experimenting in. I do this as an artist, just as you do. I wouldn’t say that I’m an artist/scientist. All these conjunctions between art and whatever, that’s not how it should be. Art has to see for itself how it can develop other ways and forms out of its own history and competence and ability, forms that have to do with this utopia of fusion we’re striving for. Scientists as well. We said to the people at DESY: “The moment you write the word “studio” above your working place, you’ve come a whole lot closer to our utopia.”
Didn’t you find anyone there where you could have installed one of your brass plates?
Unfortunately not. I always had one of these plates in my pocket… But there was a far greater openness there for the visionary. They understood my thoughts on art-fiction much more easily than my artist colleagues. Or when I said: that’s no longer technology, but technosophy.
And your virtual institute has been in existence since 1994? Can it be reached with a computer?
No. For me, this presence in the medium, also founding an organization or something along those lines, is all too far away from my work. If you become clear where this vision or utopia lies, then you also have to say no, then we won’t get into the customary swindle with labels. That’s where we have to have a lot of patience and do a lot of work until we have it for real. We say that it only has the function of a utopia: A utopia is conceived as a motor. It serves the purpose of setting things into motion or to project them into the future. Through this, its meaning is already fulfilled. I’ve planned the project New Physics for seven years, from 1994-2001. But we don’t have to have an exhibition in 2001, where the title New Physics justifiably stands above it. The further in the future the potential reality of such fictions lie, the greater their power of attraction can be. I know, for example, with the “Energy in a grain of seed”, that it will finally have moved away from the aggregate of the motor. I haven’t thought that up, it’s the result of the work I’ve done. A Belgian friend of mine is working on the project: “Singing the Sofa”. Sooner or later he wants to create concrete objects out of song. With a complex and entirely new technology occurring in between, though. In the near future, something very concrete will grow out of all these things that are purely fantastical or utopian.
That has more to do with invention…
Yes. That’s operating quite clearly in the area of a contemporary form of an “ars inveniendi”. The synthesis of art and science that we call science-fiction has had more success in prophesying over the last hundred years than the respective sciences themselves.
Do you think that artists and scientists think differently?
Science as method and process has a lot in common with art. But, after a certain point, they are two different fields and modalities of process. My project has developed purely out of contemplation and intuition. Then it became work. Making it concrete meant over a year of working within an experimental setup and… not like that, or like that either, but maybe like this… Then I went to the head of the Biology Department at the University of Frankfurt and said: “Professor Butterfass, how else can we do this?” And he answered: “Try garden cress, please”.
If everyone makes the same mistake…
Discussion with Dr. Sabine Huber-Schumacher, pathologist
Why did you study medicine?
That was due to my parents. The path was set. But the decision for pathology wasn’t. I was already interested in pathology during medical school. On the one hand, certainly because one gets a little more to the bottom of diseases, and because I prefer to work at a desk and at the microscope and to look things up in books to find a diagnosis there more than in the consultation room.
Are women as rare in pathology as they are in surgery?
Head doctors are still seldom women. The distribution is otherwise around fifty-fifty.
That’s good to hear.
Yes.
And what does the work look like?
First one works in autopsy, which becomes less and less frequent as the level of training increases. That’s the introduction. In order to later be able to diagnose tissue samples taken from living patients, one has to master autopsy, so to speak. One has to perform autopsies later on as well, of course, although not as many as at the beginning. And it’s also the case that one acquires a certain distance or habituation. I no longer have any difficulties with death or with dead bodies.
Does that occur through a conscious involvement, or does a desensitizing set in through frequent contact?
A certain normalization has set in. If you don’t work in pathology, you don’t have very much to do with very many dead people. That tends to be the exception, and here it simply isn’t the exception. One can stand the sight of a corpse without necessarily feeling emotion. Even when the sight isn’t very pretty It’s also the odor which can be greatly disturbing, but that has just gotten to be part of the everyday.
How long have you been working in pathology?
For more than ten years.
And what does your job look like?
For the moment, no autopsies at all. The routine looks like this: I evaluate material surgically removed at the Women’s Clinic macroscopically, that is, the resections of abdominal cancer or breast cancer. I look at the preparation and cut out certain pieces in order to answer questions; histologically: what kind of tumor is it, is it malignant, is it benign. If it’s malignant: how big is it, has it reached the edge of the incision, has it been removed successfully or not. Have metastases formed that have spread into the neighboring lymph nodes, and so on. There’s the quick-cut technique that takes place during surgery. Where, in the case of breast cancer, for example, the surgeon removes the piece of breast – for the most part, it’s usually no more than pieces today – and sends it via messenger to the pathology department. The patient remains under anaesthesia throughout, and the questioning begins: is it an invasive carcinoma, a malignant tumor or not. I have to answer that, which takes around ten minutes to a quarter of an hour. There isn’t that much time. For the moment, I’m working part-time – as of August of last year (1997), when the second half was just eliminated due to the cutbacks. In other words: over the past year, I’ve done the same as I did before, but in half the time. – Well, not quite half the time, because I’ve been doing part of it at home.
So the working time was cut back, but the expectations remain the same.
For half the pay. The cutbacks naturally have their effect. In this case, I’m less worried for the patients; they have to wait longer for their diagnoses, of course, that’s quite clear. But the essential thing is that it means a disadvantage to me, because I sit at home two more hours or longer in order to get the work done. I’ve set up a microscope and a dictating machine at home in order to get it all done somehow.
Is that also a reason why you’re leaving here?
No.
That’s a nation-wide thing with the cutbacks –
Here in Berlin it’s especially crass, nowhere is it as hard as it is here at the moment.
Are people afraid of being laid off, or is there an additional pres-sure?
Up until now, there haven’t been any lay-offs due to management. When people leave, their positions just don’t become refilled. Up until now, personnel has only been reduced in this way. It thins out considerably like this, however.
Do you have a vision as to how it’s going to continue in the medical profession into the future? It can be expected that the cutbacks will last; there’s no indication that it’s going to end.
Most definitely not.
Do you have a pessimistic view, or do you think that something has to be done?
In my opinion, too much medicine is being practiced in Central Europe and in America. That goes for pathology as well as for all other areas. Quite possibly, a reaction will set in due to the cutbacks that can become quite healing.
What activities are you referring to?
Something from my time in surgery comes to mind, for example: an unbelievable amount of knee joint endoscopies were per-formed that were not, in my opinion, necessary, and that certainly also had bad effects for the patient in the long run. The knee joint is an extremely sensitive joint. And so, to the damage that the knee has already incurred through some kind of accident comes the damage of the endoscopy on top of it, and that’s definitely not a good thing. There are indications for this arthro-scopy that are unequivocal, but, as far as I’m concerned, it was done far too much. That’s an example for the fact that medicine can do too much in some areas. And, naturally, in this place here, well, the liver transplantation: the whole transplantation surgery is, of course, very difficult to analyze, and I wouldn’t want to presume to make a judgment, but now and again, what’s done here seems as well to be a bit excessive. By the way, the administrative personnel here at Virchow Hospital have said to me: if you can’t handle the work anymore, then one has to think about reducing performance. That literally means saying in gynecology that extensive carcinoma surgery such as this – with subsequent intensive treatment and/or radiation – just can’t be performed anymore due to cost factors.
That would mean, then, that these patients…
… that they would be told: we can’t treat you anymore for financial reasons. But this hasn’t happened up until now. At least not here. And so for the time being, patients are treated as they have been previously.When beds are free, they are admitted and treated, as always.
And your vision? Do you think that American conditions will prevail, that only those who have money and can afford it will get treated?
I can well imagine it turning into a class medicine, but that it won’t be so crass as in America because of the so-called social net here, because the insurance companies take care of the populace and medical care of the general public is better than it is in America.
The model comes from the Cold War: the West had to show itself as being social, because there was Communism. Now that it’s gone, the social net can be unwoven slowly – or quickly – and that’s exactly what’s being done. Putting on a social attitude isn’t necessary anymore.
But all that won’t happen to the same extent as it has in America.
Why not?
Here in Europe, I believe we have a different tradition regarding social factors. In America, everyone has to look out for themselves and fight on their own, that’s the principle. And here it’s quite different; it’s not so easy to cut back or dismantle or eliminate things entirely, probably for historical reasons.
So, basically you trust in a tradition that should continue to exist even though it costs a lot. You’re not afraid that someone will come along and say: get rid of it, it’s too expensive?
€+ m J ¦ ƒ Well, what we have here is luxury medicine, that has to be said, that’s how it is. Nobody is touching the basic things for the moment. And it’s still a long way to dismantling the fundament, the medical care of the public. What’s being cut is when someone has countless massages prescribed that he doesn’t need, if he were to give it closer thought, or health resorts of some kind. Or certain operations or treatment methods that I would regard as being luxury medicine.
Do you have the impression, then, that your view of things has changed through your work?
Yes, my way of thinking and of seeing has changed. The way in which one looks at the world, I don’t mean look in a real sense, but how one sees, that’s entirely different.
That’s something that’s been noticed in pathology, that it’s about learning to see and write according to certain parameters. It’s like a school for scientific sight. On the other hand, it’s naturally greatly limited, one has to say “clay yellow” and not some other shade of yellow. The descriptions are precisely defined. I’ve seen slips of paper in your laboratory for size definitions: chestnut-sized, pea-sized, cherry pit-sized.
This “vegetable pathology” isn’t really used anymore. I enter my data in millimeters and centimeters.
One doesn’t do that anymore, say that something’s “chestnut-sized”?
No. A chestnut can vary greatly in size.
But that’s the interesting thing, because it’s an attempt to formulate something visually. These millimeters are naturally much more precise, but I noticed in pathology how much is based on comparison: pear-shaped, chestnut-sized… and suddenly, other worlds enter into it… pathologists are descriptive people.
Yes, absolutely. Morphologists. At the same time, one has to get analytical thinking in there. You can look into a microscope, but not see what’s there. There’s a motto in the pathology book by Sandritter from Freiburg that stems from Goethe, and paraphrased, it goes like this: “The difficult thing is in recognizing what we see.” I found that to be very wise, because it hits the nail on the head. One has to be able to evaluate what one sees. One has to make an analysis of what’s really under the microscope or on the slide.
Basically, one has to know beforehand what one is supposed to see…
No, that’s not the case, otherwise you’d only see what you want to see. Then you wouldn’t be a good pathologist, if you always only saw what you were supposed to see.
But that’s how the course of science has been: one sees what one is supposed to see, what one has been trained to see, and after a few decades or centuries, someone comes along and says, but I see something entirely different.
That’s a very pessimistic view of science. I don’t believe that it’s really like that.
One can only make statements at all within certain boundaries; the longer I studied medicine, the clearer it became to me that one is dealing with agreements, with understandings and with certain limitations.
Naturally. Pathology lives in a world of semblance, as well. A consensus has been met that certain criteria have to be present for a certain diagnosis to be made. A structure, a cell, or parts of cells demand this categorizing. Thus, it is a consensus. It is not necessarily the truth. If everyone makews the same mistake, so to speak, then one can subtract it. When recognition becomes com-parable, as it were, because one has set up certain categories. One has to summon certain criteria at all times in order to be able to say, “According to my opinion, it’s this because I have these criteria and was able to get to this through diagnosis”, and then one can compare the results with each other, then they permit a statement. One always attempts to agree to certain categories to remain comparable, to be international. That’s quite true. And certainly there are comparable aspects in the modern art of Europe and America.
What just occurred to me: in pathology once, during an autopsy, I became frightened because all of a sudden I was able to see that it was all beautiful, too. I can still remember how the pathologist took out the “heart and lung tree”. One has these anxieties and fears of the corpse and the smell and so on, but after the first quarter of an hour, when I had forgotten that this was an autopsy and was entirely concentrated on what it was there that I was seeing, I suddenly had the thought: “Oh, but that’s just beautiful. That’s not disgusting in the least.”
I can’t understand that at all, I never found that to be the case.
A liver like that just looks beautiful. Or the way the organs are situated, the way in which everything has its place. Somehow strange, this logic, but also very aesthetic. Or microscopy –
Microscopy is something different. That’s more foreign, distanced. That I can understand. That’s another world for me, however.
Do you like to use the microscope?
Yes.
You say that it’s another world. Because it’s abstract? With mi-croscopy, one has to choose among very limited descriptions for what one sees – and one sees a lot.
Yes.
And so the real achievement actually consists in not describing these 200 shades of yellow that one sees, but rather to know when one says “clay yellow”, even when it’s a bit greenish or so…
Yes, that’s right. The exact definition of color is not what’s important. It’s about being comparable, to work out criteria for a diagnosis on the basis of what one sees.
So that the next doctor that reads the diagnosis…
… and also in order to found a diagnosis. There are cheesy necroses, that’s the morphological substrate of tuberculosis, and there are clay yellow necroses that go along with a heart attack. That’s the destroyed heart muscle. A certain insight lies behind these expressions which points them in a certain direction. So that the expression allows for a certain diagnosis.
The expression itself is already basically a sign, almost an in-struction for action…
A small part of it, at least. Macroscopic observation and histology complete each other. Thus, when one says: “cheesy necrosis”, and means tuberculosis, it’s not only this macroscopic whitish, crumbly aspect which does indeed appear different than the necrosis of the heart attack, but behind this also lies the diagnosis “tuberculosis”, which one infers from that, with the histological certainty, of course. And the histological certainty, as well, is based on established criteria. That’s morphology. The appearance of something. Whether under the microscope or with the naked eye, it’s the appearance.
That’s right. It’s basically always about the…
Form.
Laments, Dialogues, Litanies, Rhapsodies and Curses
Letter from Morgan O‘Hara, artist
I have always been attracted to highly structured disciplines. They seem to counterbalance my basically intuitive nature. The order, questions, methodology and publication of results reassure me. I am particularly stimulated by cosmologies and schematic diagrams of systems of thought. I like the way they look, all laid out like surgical instruments in an operating room. One can see at a glance the interrelationships between concepts, intentions and processes. I like the feeling that everything has been considered and is now in working order. Of course, this is an illusion, but it is consoling non the less. The demands and unpredictability of quotidian detail, emotional volubility and human interaction can at times be overwhelming. The ever encroaching mystery of meaning seems somehow to be kept in balance by these grasps at comprehension and systematization.
In my art, I invent systems by which I approach a process which I am living. All of my art deals directly with life and meaning. I use time and space as the parameters within which to work and I render visible certain aspects of lived experience. I have been fortunate in that my work has at times provoked challenges and stimulated discussion among people in the scientific arts. These conversations over the past 20 years have always led me toward a better understanding of my work and a better grasp of the process I employ. They have also generated collaborations which have become art.
More often than not an individual scientist saw my work in an exhibition and approached me with an idea or something which he or she thought might help clarify, heighten or enrich the concept or process of my work. Most often the conversation led from one thing to another and resulted in a sort of collaboration. As the computer age evolved, I have been given access to the equipment which scientists have in their laboratories to realize aspects of my work which are difficult without special tools. In the case of David Birch, a mathematical psychologist, our collabo-ration became a part of the scientist´s actual work. Perhaps some-time in the future a collaboration will become fully interdependent. That would please me. An important difference between scientific observation and art lies in the working method. Once a scientist sets up an experiment, the rules of collection and analysis must remain as initially stated, otherwise the results are considered invalid. In my work, the rules ajust, as art and life require evolution. Change must be an essential component of any work with the express purpose of rendering visible and transmitting vitality through form. Scientific concepts, analogies and tools are interesting and useful but my work is art. In reflecting on major differences between science and art one sees that simple discussion of left and right brain functions is not sufficient; nor is that of creativity versus rationality; nor, spontaneity versus method. It has been my experience that both scientists and artists are working with basic principles of existence and materiality. We are working to discover the unknown, to render comprehensible or at least physically present an idea or concept which has something to do with life and meaning. Hours and months and years of slogging research, self-questioning, frustration with materials and inevitable bureaucratic practices to bring projects to fruition are a part of the process and easily take up half of an artist´s time. It is the same with scientists. Moments of vision and spontaneous creativity can lead to years of data collection, failure, reports, publications, politics. As we work as scientists and artists, we are engaged in all the lyric forms: laments, dialogues, litanies, rhapsodies and curses.
Most of the scientists I have met have a great sense of playfulness and curiosity, and this has been the basis of communication throughout our collaborations. A sense of mutual respect has always set the tone as we work on an idea, a process, a visualisation. As artists and scientists we are trying to apply the known to the discovery of the unknown. The mysteries of life, both visible and immaterial, are the substance of and motivation for our work.
It’s true that I say to some patients that I will treat them, but I only say it to people when I know very well that they don’t really need much in the way of care.
Discussion with Dr. Jochen Groll, specialist for internal medicine
What do you do professionally?
I work as a specialist for internal medicine focussing on kidney diseases. In our region, I try to offer medical care so that specific internal problems can be treated, and on the other hand I carry out blood dialysis for people with terminal kidney failure.
Is dialysis not hit by cut backs?
At the moment, dialysis has not been subject to budgeting, and it guarantees us a relatively safe income…
you have regular customers as it were…
Yes, they provide me with a predictable income. That compen-sates for the scarcely relevant income which one has as an internist these days. It is simply no longer worth working merely as an internist, unless you require very little space and no personnel. Talking to your patients, taking decisions together with them and assessing risks is economically impossible – at least, it certainly doesn’t pay.
What kind of patient needs dialysis?
Primarily older people. The unlimited acceptance for dialysis means that every 80 year old can be treated. At an advanced age almost everyone has vascular complications which may often lead to kidney damage. The second large group of patients are the diabetics. In the course of their illness they often develop chronic kidney trouble, and then they come to us. But there are also kidney diseases which people have from birth and other special illnesses – they constitute a smaller percentage.
Is there a specific kind of person who is hit by kidney disease?
There are few epidemiologic studies on the subject; hardly any in Europe, in Germany none at all, there has been more intense research in America. The impression this has given is that kidney disease occurs more frequently at specific levels of society; the lower classes are more often hit, and there are also socio-cultural and race-specific differences. A conscious relation to one’s body, better nutrition, more sensitive handling of defects – these possibly play an important role in the extent to which kidney disease becomes manifest and whether a person requires treatment.
Do you also work scientifically?
Yes, we investigate the illness factors which may promote the emergence of terminal kidney insufficiency. We ask ourselves which illnesses lead to dialysis. We aim for a more precise understanding of the vascular genesis which I have already mentioned and we also examine genetic factors which might favour the onset of terminal kidney failure.
You do this together with your colleagues…
We can’t do very much as registered doctors, but we try to investigate smaller questions, ones we can grasp and are equipped to work on.
What is the motivation? Does it mean additional money, or is it an urge to research and simple interest?
There is no money in it, we are still interested. It is an attempt to create the synthesis between scientific medicine and medical care, which are the two essential aspects of medicine. You have to try to maintain a scientific approach, that is what we believe as orthodox medical practitioners. So we make efforts to answer spe-cific questions more precisely than they are generally answered, for example with regard to diabetes and vascular problems. We should like to be able to be more precise, is it perhaps the blood vessels, is it perhaps the arteriosclerosis which has led to the damaged kidneys?
But how can you differentiate?
– by means of the blood vessels, by means of angiography and by taking a tissue sample from the kidneys.
So then you would be able to subdivide the patients into two clear groups?
Yes. Now if you go into a dialysis centre, you realise that you only know why less than half the cases need dialysis. Ultimately most cases are unclear.
The cases are not clear, but you take action, nevertheless. That often happens in medicine. On the one hand, it is defined as a science, but it is a very vague and blurred field.
Yes, precisely.
How do you cope with that? Do you hope for increasing illumination from an analytical and classic medical point of view, or do you think that things will always be that way, that it is a condition of human existence that not everything can be explained? The cause of illnesses can always be traced one step further back, you can construct a chain of cause and effect and say the patient has arteriosclerosis – to take an example – but why, he has eaten the wrong things or he has smoked, but why, perhaps he is depressive, but why, perhaps he had problems with his mother and so on…
This question is very ambivalent. It is possible to turn it into two questions. The question: would you like more information, more knowledge in order to be able to treat your patients better? Quite honestly, I must admit that I don’t wish for more knowledge. Knowledge is an illimitable term; knowledge, information never stops. Probably knowledge never converges towards a limit asymptotically, but will go on forever. And knowledge has the great disadvantage that it makes the ways towards a decision become more difficult and medicine is about taking decisions. The more information you have, the more difficult you suddenly find it to come to a decision regarding treatment. So more infor-mation in general does not interest me, but specifically as a nephrologist, information relating to the questions which I am now investigating…
If you are caught up in your detail, in your small channel of knowledge…
of course in my channel of knowledge I am interested in infor-mation, and there I do believe that new information can lead to new decisions and can also assist us.
But the pool of knowledge that is illimitable is composed of precisely this kind of detailed knowledge! Your contribution will be added to the pool and others will also have to swallow whatever you have found out.
Nowadays we have this diversification and there is no longer any way around it. So I just cover one tiny sector of knowledge, and within this area I am grateful for information and insight.
And everything else is too much for you…
Yes, I must admit, really that is too much for me. Occasionally I am distressed by the fact that I don’t know more about the heart and the stomach and the bowels, but then again I am pleased that I know rather more about the kidneys. It seems to me that this is the route things are taking, certainly each person must try to find out more information within his own sector, but he needs to seal off the sector, he has to close it.
However, there is a danger in that, people may become narrow-minded and fail to understand the contexts – what happens to the heart also effects the kidneys, and then no one would be able to recognise that any more.
Precisely. Perhaps we must create a hierarchy of information determining which information really should be available to many, and what sort of information is not so important that every doctor needs to know it…
But who is going to conceive this hierarchy? it would have to be leading gurus who know and can classify everything down to the smallest detail, who is to decide what is important?
These are not gurus perhaps, but structures, organisations where people meet and exchange views. I also see the creation of this network of communication as a task for the future. The media and the technology are there, we just need to construct a good structure, and to wrap up and address the information well, that is the great art. I believe that a great deal will change in medicine in the near future. We have to try to shape the communicative forums in such a way that certain information is transparent and easy to call upon, whilst other information is not generally accessible. As a result of the media, we already have that problem anyway, on the Internet too – very soon we will have to make decisions: I am not going to enter this sector any more.
… You mean each person finding his own way and not constantly receiving information that he didn’t want at all…
Yes. There are already exciting and quite conceivable ways of organising this better. Alone the fullness, the density of informa-tion today creates a lot of problems. Currently – of course I can only assess things in Germany or even in the Berlin area – this has led to great uncertainty in the basic care of patients. Of course at the highest level of care it has also had some very positive effects – at the university clinics. All that is called for there is to take up a position with regard to a theme which you yourself have researched and worked on and know. You keep the person, the patient or the guinea-pig there for as long as you receive information about the operation or the treatment for him. But then the patient is outside again in the huge undertaking called medical care, and there he meets with the doctors’ uncertainties because the decisions here are no longer so firm. Medicine has two essential aspects. One is science and the other is medical care. The patients only receive one of these, but they need both. On the one hand there is the scientific side, which can no longer be grasped in its entirety, not by anyone, and the other is medical care, which must be provided each day. I think that we must make this division between medical care and scientific medicine more severe. And the second necessary step would be the communica-tive unification of both.
What function would interest you most, if this division were to become more pronounced?
The scientific function.
You are not so interested in medical care?
No. It’s true that I say to some patients that I will treat them, but I only say it to people when I know very well that they don’t really need much in the way of care. Perhaps they have a small problem, or a special kidney problem. Otherwise, we only make our diagnosis about specific kidney problems, it is important to us that the medical care of the patient is undertaken elsewhere.
But don’t ever go buying yourself an afro wig
Discussion with Peter Henkes, art historian and curator
I am an art historian and curator in Amsterdam, and currently for an exhibition in Berlin at the Künstlerhaus Bethanien, as well. We had an exhibition in Amsterdam at the New Metropolis Museum, where we presented works that were jointly made by artists and scientists. We had invited six scientists and six artists to work together for six, seven months. They were to put together a pre-sentation either at the end of this dialogue or in the interim. We also said, though, that it didn’t have to be a piece of art with a great scientific idea or a scientific exhibition with an artistic topping poured over it. It should be a real interaction, and the presentation should contain some of the qualities of both disci-plines that would then interact with each other.
How did you come up with the idea of bringing together art and science?
If you go to a museum, you expect to see art, and in a laboratory you expect science. You don’t see what’s there, but rather what you expect to see. The first idea was to present scientific images as art in a museum. But then, together with my colleague Iris Dik, I gradually let go of the whole theoretical idea of how it should be presented: and of what art is, what science is. And so we wanted to let artists and scientists work together and see if there are possibilities for creating models for a further collabo-ration between both these disciplines.
And what did you both expect from this? Artistic results of another kind, or that this would inspire scientists in another way?
Not really. We anticipated that we would find a certain attribute that both art and science possess. But most visitors regarded the works as art, which was disappointing.
Why was that disappointing?
I had hoped that something could develop that visitors wouldn’t be able to classify as being art or science. But people went to the scientific museum and said, “Hey, these are art works!” Certainly, a work of art can’t and is not supposed to be a scientific work, and a scientific work isn’t supposed and cannot be a work of art. But what does this object mean, seen from a scientific or from an artistic perspective? In principle, art and science are connected to each other in that both are not moral. They are entirely free for inventions and discoveries. Artists and scientists do things society then has to deal with, because they’re there. But one difference is: the artist is not allowed to create genuine matter. An artist would come into conflict with the law. A scientist who develops a substance that can kill millions of people, however, is none-theless a good scientist. I’m no scientist and no artist either, and these concepts mean very little to me. I don’t know what science is and I also don’t know what art is. But I know what art isn’t; that’s what I studied for. Science relates to measurable things and to falsifications. But the essence is that science is involved with discoveries, and art with creation. If you discover something, then it’s already there and only needed to be discovered. It’s interesting what’s happening in biogenetics. People get very upset about it, but it’s still presented in science as a discovery.
It’s basically not a problem of modern times, but now, in respect to the genetic possibilities, it’s become very explosive.
Yes, and certain rules go for artists, for those that work creatively. Art isn’t supposed to be political. It can be political, but then only leftist, never to the right. These are unwritten laws. Have you ever seen right-wing extremist art? It doesn’t exist.
No, but that also has political reasons.
Yes, but in a liberal democracy that today…
… we can place the values as we like: so, no right-wing.
For example, in China there are paintings thousands of square meters in size of Mao in the sun that have been painted anony-mously. We don’t call that art, but rather political propaganda.
The pyramids in Egypt were also…
Yes, that was the art of the ruling class, or their propaganda.
… Ceausescu, with these…
Ceausescu’s palace is a bad copy. He was an idiot of propaganda. I like to live in a liberal democracy and I wouldn’t like to live in a totalitarian state. It’s about the fact that there are certain rules of the game that determine what one can do…
You are repeating categories of the political field here in which you live, not those of art. The definition of art in a totalitarian state is different than it is here. And so, what gets called art depends on the social or political background. There are no fixed norms for art or for science, everything depends rather on the political domain in which one lives.
In the 19th Century, one could still say that a work of art was elevating and beautiful, now it has to be very interesting. Other words are utilized to find other properties. But it’s about the fact that art operates according to certain rules of the game. On the other hand, scientists today propagate fluorescent mice, clone human beings; they’re doing fairy tale-like things, and they don’t have to abide by the same rules as artists do. I know artists that would love to create a new plant, but that’s forbidden, only scien-tists are allowed to do that – because they’re only discovering what’s already there.
I think there’s something not quite right there somewhere.
What’s not right?
I think that something similar is happening at the same time both in art and in science. Morphing recently turned up as a possibility in the graphic area. You can make a pig’s face out of a coffee pot. And in research, a tomato is developed with heat-resistant genes from a potato or a mouse. This jumping the lines of genera and this breaking of norms that have been in place for millennia is present in both fields…
Yes, but the big difference is: when the scientist makes a fluores-cent mouse, it can grow and…
And in art, you can copy it and copy it and copy it some more.
Yes, but nothing would walk in through your door there. Scientists create living beings, and artists aren’t allowed to do that.
Do you find that to be a shame?
That was one of the most important reasons for me – what would happen if one were to present science as art, if one were to stick it in a museum. Science has a higher niveau, a higher level of criteria in regards to content, effect, fantasy, and the way in which it has been presented over the past years. But art has a tremendous form, with no content. Science has a very small form, yet it has a tremendous content. And I wanted to see if this could be mixed. Whether or not one could give science a larger form, for example, in an art museum. Science always goes to the outer limits. Yes, if a scientist doesn’t go on to the end, somebody else will. Just like that…
But then what’s the matter with art?
Why do we need art? As entertainment, that’s something very important. Otherwise, there are artists that change the way in which the world is taken in. I think that art especially has this strength. But science is acquiring more and more of this as well. Art is a type of civilization. And one can see that art is becoming more and more achievement-oriented. Taste is also getting finer. In the 19th Century, you had a huge piece of meat on your plate, and today you’ve got two or three little things which you taste but don’t really taste, you have them in your mouth or you smell them, you have them in your hand or you hear them. That’s how art of this time is, as well. It demarcates, which is very interesting, because it moves into a direction of thinking and not into a direction of action. It’s trying more and more to absorb into every kind of social interaction. Art will dissolve itself in the time to come, as has already happened, for example, in advertising. Artists now make art that looks like advertising, but it’s art. Artists can call anything into question at any time. When money plays a role, you can’t call anything into question. Art vanishes, for example: Fluxus. There’s some piece of burnt nonsense left over from an action, and it’s in a museum now, which is completely idiotic, one can’t possibly take that seriously. The essence of a museum is to accumulate and to historicize. The entire history of art, however, is an illusion; it’s a continuity of a discontinuity. In twenty years, museums will be over and done with; in the seventies, art museums were hip, and now, 99 percent of all museums have become mausoleums. That happens personally, as well.
But what you just said about art history also goes for scientific history…
Science is also political, of course, but we live in a liberal democracy, and liberal democracy is the most fertile political system, because liberal democracy has doubled around the world over the past fifty years – and in another fifty or a hundred years, the whole world will be a liberal democracy.
Yes, and the biggest “liberal democracy” will rule over the rest.
No, I don’t think that one state will rule over another; in a liberal democracy, it surely isn’t the government… it’s about the firms. Firms have the freedom to rule the world.
Whoever has the most money buys the world?
You don’t have money, but rather you use it… money is like a wave, like millions of waves everywhere around the world, and you can ride on one wave for a minute or for a year, and then it’s gone again. Money is not fixed, money is worthless when it’s tied down. It has to move.
Does one have to be in the situation in order to…
… move money, and the one that does it is the most successful, that’s been proven. George Soros, for example…
So, you think that liberal democracy is the most practical thing in order to move money…
… and it also protects the people that don’t have the possibility to move money. A liberal democracy is for individuality. What would have happened, had I said that in this country fifty years ago? I would have been executed. But we have to concentrate on the question of art and science. It’s more of an attitude of how one expresses something. Artists are always involved with the ultimate consequences; so are scientists. Scientists have a frame of thought, but artists don’t have this – they only have themselves or a neighbor or a gallery, an exhibition. That is very difficult; artists have to fight history. Scientists only have to build upon things… Perhaps it will be said one day that science was the expression of entirely individual positions, and that it was all so beautiful indeed, people thought up all kinds of things – well, you know, they were utopians. These laws only apply on our earth, and out there is space and time. We can’t imagine it any other way, although there are scientists that already work with twelve dimensions, I can only imagine three, and the fourth is already…
… taxing.
Whatever happens in the future, it will nonetheless not all have been in vain. We’ve always gotten the furthest with what we’ve found and invented ourselves, and that has been science and art. I don’t think of it in negative terms; I live in this time. Joseph Beuys once said something like: “Would you say the same thing if you were standing on the moon?” Stupid question… this inflated, semi-philosophical questioning around… I can’t act as though I came from somewhere else. Everything I say has to do with the fact that I exist here.
Despite that, it’s a good thing to acknowledge existing boundaries and to wonder, how would it be if I were an Indian or an African…
That’s very good in order to…
… establish a relativity of one’s own position.
… but don’t ever go buying yourself an afro wig…
… a what?
An afro wig.
Why, do you have experience?
No, but don’t try it, just imagine it. So, that’s the story of art and science.
The advocate of the unborn
Discussion with Dr. Wolfgang Henrich, gynecologist
… Schipperges, a medical historian from Heidelberg, once expressed the formulation that medicine is neither a natural science nor a social science, but rather a science of action. And a science of action is based on experience. It just can’t be denied that people who practice the same profession for decades have, especially in medicine, seen so much that they can reach a diagnosis and the right therapeutic recommendation quickly. To quote another famous individual: “One only sees that which one knows”. And these ultrasound machines make this possible with-out side effects, for the time being I’ll say nearly without side effects, but probably entirely without side effects. The image on the monitor, finally, has to be compared with what one has already seen. It’s a constant reflection between a value of experience and the new image. When aberrations turn up, a little alarm signal goes off. Then it has to be checked out whether one is dealing perhaps with a variation on the norm, or with diseased findings. That is ultimately the job to be done: A permanent filtering of every visual impression, filtering out things that are not part of the rule. The only danger with ultrasound lies, as is the case with every method, in implementing it without any good reason, or in interpreting the results incorrectly.
It’s not that easy in medicine to tell when using something is justified, precisely because medicine doesn’t have a purely scientific basis. I spoke with a methodologist from Steglitz, and he expressed the opinion that there are clinical studies for everything; some assert one thing, and others the exact opposite. Significance on both sides. And for this reason, trust in clinical studies, which very often prevails among classical doctors, should be enjoyed with great caution…
That’s correct. And the longer you’re in the “business”, the more often you’ll experience that what goes today will already be refuted tomorrow. But a few things definitely remain. Sometimes counter-points have to be set up first which each prove the exact opposite, so that gradually a method can develop somewhere in the middle of this pendulum and one can establish when this method is really meaningful. This aspect evidently keeps me working. When a pregnant patient comes in for a check-up, nobody knows yet what it looks like inside her belly. And to find out how the child is doing, whether it’s healthy – as far as one can determine this with the image-producing process -, whether it’s a boy or a girl, all this continues to arouse my curiosity. I’ve already performed more than 10,000 examinations now over the past eight years, and it’s always a new discovery of this unborn life. The next important aspect is that the woman obviously can’t look inside her own belly, and she often comes with a great deal of fear or anticipation. It gives you a good feeling, then, when you can show the patient on the screen during the examination that the child is all right.
There’s also the concern that the more precisely you can diagnose people, the more you’ll be able to control them. Then it would be possible to say, for example: “If you carry this baby to the full term, we’ll stop insuring you.” We can already see what they’re doing in America with these gene cards; children from genetically endangered marriages are no longer being insured. The danger is that the state, the insurance companies or other institutions will gain an enormous power with these diagnostic procedures.
That is theoretically conceivable, but I believe or hope that such a development will never come to pass. The fear of selecting life is entirely justified.
What does your daily routine look like?
My normal working hours are from eight A.M. to around five P.M., and then there’s the so-called on-hand service six to eight times a month, which means that the majority of my colleagues go home at five, but three to five of us stay on in the clinic, and we’re responsible for taking care of all the patients.
… and sometimes deliveries occur during this time…
… not only do they sometimes occur during this time; we no longer have any so-called programmed deliveries at all. There was once an era when the programmed delivery was the rule, that is, one saw to it that as many deliveries as possible were performed in the core time between eight and five. There was the conviction that the highest degree of security could be reached through a maximum on personnel, doctors who were as alert as possible, through an intact infrastructure, logistics, etc. But precisely in delivery, where one should intervene as little as possible and let nature run its course to the greatest possible degree, we produced pathological results ourselves. For example, contractions were reinforced at a time when the body wasn’t yet adjusted to them. After this era of the programmed delivery, we’ve returned to natural birth, and it’s left up to nature when birth occurs and how it progresses. And so, in a 24-hour day, we have a very good normal distribution. That’s a big problem, because one often works through from eight in the morning to eight o’clock the following morning without a break, and the workload reaches people’s limits. This system of on-hand duty is a purely financial question, which means that you’re not paid for a normal working hour, but considerably less.
But one has to do them anyway?
Yes. If you wanted a shift system so that everybody had a good night’s sleep behind them, then it would mean a considerably higher personnel cost, which would be unaffordable. At least at the standard we’re offering and have to offer in international comparison, as well as for humane reasons. And within the context of additional cutbacks, those that are left are subjected to even more additional strain.
And that’s the tendency for the time being?
That’s absolutely the tendency. It’s been noticeable over the last few years. The pressure is increasing. That’s a not very nice development altogether in the university landscape, and for this reason I believe that a person’s job here in the care of patients, teaching and research represents a very high demand.
Did your job cause any personal change, did you acquire a different relationship to your own body, or did something change regarding your concept of body?
One point is that my respect for human life has increased, and my fascination for the development of human life as well. In the final analysis, it’s still a miracle of life, and although we can see so much, it still remains entirely incomprehensible. My own bodily consciousness has increased; I’m thankful to be healthy and I behave according to that. That’s often not the case with the patients, however. The demand there is extremely high on society and on therapists, but when one approaches the subject of personal responsibility, then first of all a kind of astonishment arises with many patients. Concerning smoking during pregnancy, for example. Among, say, one hundred heavy smokers, I achieve, despite intensive informing, visualization and making the connections intelligible to them, probably only ten to twenty percent who really change their behavior as a result. And that’s very sad, of course, but that has a lot to do with the addictive potential of nicotine or with the fact that pregnancy itself re-presents an exceptional situation. And precisely in a stress situation, and when the woman’s social environment isn’t supporting the pregnancy, reaching for a cigarette is, from the patient’s perspective, unavoidable. That’s a great problem, and that’s the moment I feel like the advocate, the lawyer, so to speak, of the unborn – because that’s an intact person in there that can’t defend itself in the small smoky chamber of the uterus. If you take a look at it with ultrasound, at how the child’s behavior changes under the effect of nicotine, how it becomes quieter, when you see all these short-term changes, then you can really get scared and want to help this little being. That’s the helper syndrome.
So, you have a feeling for that black and white thing moving there on the monitor?
Of course.
And it doesn’t wind up getting so abstract, that it’s just a kind of –
No. Sometimes it happens to me, as well, that I recognize a baby during a repeat examination, although I can no longer remember the mother.
One sees what one has been schooled to see…
Yes, but there are always further developments in the means of seeing, small steps. And in order to counteract the boredom of daily routine, there’s also the possibility of researching a little or conducting studies, collecting new discoveries and publishing them, too. One has to say very clearly, though, that revolutionary achievements such as the introduction of penicillin or the laparo-scopy, that is, operating without opening up the abdomen, the so-called button hole surgery – achievements in medicine such as these can certainly only be expected at very great intervals. Then, for many years nothing happens at all, until a revolutionary method or therapy that has a real significance for human beings is found again. In my area, the so-called real-time 3D sonography is presently being developed. When this comes out, we’ll have a sound instrument in our hands that can show us a child as though it were in a glass box. In medical research, science is performed mostly by doctoral candidates. These are young medical professionals that haven’t yet completed their studies and are doing their doctorate on a theme which they delve more deeply into, work on scientifically, and through the publication of the results, they achieve their doctorate degree. This takes place under the supervision of experienced colleagues or professors in the clinic and without pay; the title itself is the reward. There are, too, as far as they’re interested in any way, offers and money from industry. Above all else when the industry expects some kind of benefit from the results. This occurs through the multiplication effect, that certain trend-setters, respected doctors use the preparations and achieve success with them, and then others would like to imitate this success. And so, a spread of the preparation is the result.
And in this way, the market orientation trickles down to the hospital.
If one is completely honest, and one is naturally treading dan-gerous territory here, then doctors are only people, too, and entirely susceptible to financial support. And it’s conceivable that dubious colleagues or scientists are using preparations, testing them in studies and coming to results that are embellished in favor of these products in order not to anger the sponsors. That is a very delicate statement I’m making here, of course, and for this reason I’m going to emphasize once again that this only applies to the dubious colleagues, that unfortunately also exist. They exist in every profession. Dubiosity always gets revealed somehow, though, at the very latest when a counter-study is carried out by another concern. I think that the truth prevails, also in medicine. When a lot of studies are done, and they’re often carried out several times, then in the end, the one who has been making false assertions will stand there alone and become the subject of ridicule.
Can one believe that a majority of professionals are necessarily going to think the right thing?
In the long run: Yes! One thing is clear in medicine: The majority are not always right. But when individuals are right, then the majority goes along with it. I experience daily, however, that colleagues, especially the young ones, have innovative ideas and want to change something in the clinic, introduce a new method or something to that effect. At first, the majority – especially the more experienced – are skeptical and reject new ideas at the onset according to the principle: “That always worked out that way, it’s been our experience… We’ve never done it any differently, and despite this we’ve been practicing sound medicine!” And so, new innovations are often not even really reflected upon, but rather cut down right at the beginning. The farmer won’t eat what he doesn’t know. That naturally puts a damper on innovation. On the other hand, not every innovation someone thinks up is really meaningful.