Book Review

Art, Surgery and Transplantation

N Engl J Med 1998; 339:1007October 1, 1998

Article

Art, Surgery and Transplantation
By Sir Roy Calne. 227 pp., illustrated. Baltimore, Williams & Wilkins, 1996. £45. ISBN: 0-683-23094-8

Sir Roy Calne, a world-renowned transplantation pioneer, presents in this book a unique blend of art and the pathos of transplantation surgery. As is the case with many uniquely talented surgeons, Calne felt an early urge to draw and paint, which resulted in the magnificent copy of Degas' “Ballerina,” shown in this book. Calne's artistic training was enhanced when he met the great Scottish painter John Bellany, who became his patient and received a liver transplant. The resulting friendship and tutorship stimulated Calne's ambition to depict the high-tension events of transplantation on canvas. Touchingly dedicated to his patients and what they have suffered (including sitting for portraits), this book is the first to present the miracle of transplantation in a series of paintings. Calne's creations project the intense fear and pain of terminally ill patients awaiting transplantation. He also depicts the triumph of transplantation in the patients who have recovered.

Calne focuses further on the drama of transplantation medicine by providing portraits of pioneers in the field. Beginning with his unforgettable “Moment of Truth,” showing his own operating room before the insertion of a new liver, these paintings provide a gripping view of transplantation. The “gestalt” of the transplanter is projected with particular sensitivity in the paintings of the pioneers. The painting of the Pittsburgh patient awaiting a baboon's liver brings us to the forefront of current research in transplantation. Calne's paintings of children before and after transplantation are particularly touching. Who could ever forget the sick, wasted, jaundiced little six-year-old girl, and her young-old face after transplantation and recovery?

Calne's view of art was inspired by the classics, and he often thinks of art in terms of the early surgical interest in anatomy. He includes illustrations by da Vinci, Vesalius, Rembrandt, Goya, and Dürer, which provide an elegant and cohesive background to his own work. The vivid painting by Kahlo, which projects an almost audible sigh of suffering, constitutes a particularly impressive prelude to his work in transplantation.

One key element of his book is Calne's deep personal involvement with his patients. He wished, in particular, to give patients greater hope for the future. This is especially true of pediatric patients, who are in such acute need of human caring and affection during their times of almost overwhelming stress.

As creative and productive a painter as he is a renowned surgical scientist, Calne covers several additional areas of interest. His paintings of Monet's “Garden in Givry,” the “Semi-Nude,” and the “Game Bird” provide a striking blend of colors that speak for themselves. The colors and expression in his painting of the recovered yeoman and warder of the Tower of London after two liver transplants also belong in this category. Equally impressive are Calne's sketch of a fighting bull from Valencia and the Van Gogh–like “Threshing of Grain in Bali.” Calne's foray into Asiatic art is also of interest, and his depictions of fishing cormorants in China and a Japanese doll, as well as of Chinese handwriting, add an intriguing dimension to this collection.

This book presents an elegant blend of the emotional travails of an exceedingly difficult modern surgical discipline — transplantation — with a gifted artist's view of the constantly changing scenery of this field. Not traditionally representational, Calne's art bears elements of the primitive, with occasional glimpses of impressionism. What Calne has managed to depict on canvas is not the exact image of each subject. Rather, the paintings project the innermost thoughts, hopes, and fears of patients as well as colleagues. This book provides a vivid example of the kind of heart and mind that are necessary for a person to become a great transplantation surgeon — or for that matter, a great artist. I recommend it with enthusiasm to readers involved at all levels of health care. Its impact is universal in that it provides unique insights into the level of nobility to which humans can aspire in times of severe stress.

Felix T. Rapaport, M.D.
State University of New York at Stony Brook School of Medicine, Stony Brook, NY 11794