Transplant pioneer Sir Roy Calne found painting his patients helped him to understand them and, writes Karen Gold, taught him something about himself.
"The nice thing about sculpture," says Sir Roy Calne, pioneer transplanter of kidneys, livers, pancreases and intestines, "is that if you get it wrong, you can lengthen an arm or shorten an arm, and nothing bleeds. "
Given that the professor emeritus of surgery at Cambridge University began his career by removing kidneys from corpses still warm in their hospital beds as live patients watched the blood flow under the shielding curtains across the ward floor, it seems a surprisingly fastidious thing to say. But then Calne is surprising: a squash player and a classical guitarist; notorious tongue-lasher of health service administrators but kindly medical teacher; flamboyant snapper-up of transplant organs via Rolls-Royce and helicopter, who holds patients' hands as they sink under the anaesthetic.
As a child in Surrey, Calne often painted and drew. When he went to Guy's medical school at the age of 16, he worked at copying a Degas portrait in the National Gallery in his spare time. On national service in Singapore, he learnt Chinese brush painting.
During his medical and surgical jobs in Oxford, Harvard and St Mary's, London, when he first fought against the prevailing assumption that kidney transplants were impossible and then challenged the belief that radiotherapy was the only way to trick the body into accepting a foreign organ, he found that many surgeons used art for relaxation.
What was to set Calne apart, though only after he established a worldwide reputation for successful transplants backed up by the inspired use of immunosuppressant drugs, was the subject matter of his paintings. For they are not relaxing at all.
A catalogue of Calne's work, from exhibitions such as his most recent at Churchill College, Cambridge, makes for gruesome reading. Not everything is surgical: there are portraits of great scientists, sculptures of dancers, as well as works based on Dolly the cloned sheep and Watson and Crick's discovery of the structure of DNA.
But dominating the display are his portraits of very sick transplant patients. There is the "before" drawing of an empty abdominal cavity, and the "after" drawing, with transplanted kidney, liver, pancreas, stomach, duodenum and small bowel put back in. There are the operating theatre scenes, including the quasi-religious The Moment of Truth, in which the surgeon elevates the new liver destined for the patient below.
Of course, Calne is a surgeon so he would have no squeamishness about any of this. Some members of the public might, he agrees, but not other artists. The sculptor Laurence Broderick, who made the bust of Calne that stands in Addenbrooke's Hospital, was delighted by his subject's proposal to rest his sculpted hand not on a dull old chair, but on a human liver.
"When I suggested it, Broderick said, 'That's a great idea, but I don't know what a liver looks like.' So he gave me the clay and said, 'I'm going to have lunch, you make the liver.' He went off and I did. I found it very easy."
That was four years ago, and Calne immediately began to learn sculpture. A similar episode in 1989 prompted him to try painting his patients. The artist John Bellany came into Addenbrooke's for a liver transplant, and after the operation requested paint, brushes and a shaving mirror so he could portray his coruscating experience.
Calne, fascinated not only by Bellany's technique and productivity - the artist covered the walls of his room with 300 paintings during his stay - but also by his highly subjective vision, asked if he could paint him, too.
"I showed him some of my stuff and he said, 'Throw all those dull colours away and get some bright ones.' He said he would give me some help, and we painted together. We had very different perceptions: he saw himself like St Sebastian, and I saw this almost dead alcoholic who could do nothing but sit in a chair and drink milk."
As he painted, Calne realised that in transplant patients he had an unprecedented artistic subject. Nothing could have motivated him more powerfully. "I thought as a surgeon painting patients, nobody has ever done this before, and that's really what got me. I like to do new things; I have always been stimulated by being told you can't do it or it's difficult and you shouldn't do it, or that other people haven't done it."
He began to ask patients if he could paint them. "I think initially they found it surprising, but everything about transplantation is surprising. It was just another weird bit of the whole picture. Rather less painful than most."
While adults confided family details to him, children, in particular, found being painted reassuring, he says. The man they knew might save their life but would definitely do horrible things to them in the process now also gave them sketches of themselves to colour in. As he began to understand more about his patients by painting them, so he began to consider what art told him about himself. He found a blank canvas less intimidating than a bare torso, for example. "I don't seem to have the same awe some people have about the blank canvas. A block of stone that you have to start cutting, that's a bit more awesome. If a patient bleeds unexpectedly, if there's an artery in the wrong place, that's what really scares me."
Nevertheless the actual processes of art and surgery are remarkably similar, he believes. "You need reasonable hand-eye coordination. You need to select the right tools, the right materials, in the right sequence. You need a composition concept of what you are going to do, otherwise the whole thing will be a mess. That's true of surgery just as much as painting."
But it is, above all, the emotional conjunction between art and surgery that Calne has set himself to explore. Several times, in painting and in sculpture, he has tried to capture what he calls the "unique sacrifice" involved in transplant surgery: that the organ donor has at least to risk death, and generally to die, in order that the recipient might live. It is an idea that, in reality as well as in art, many people prefer to ignore.
Calne has always squared up to it. When he started transplant surgery, he would toil for 24 hours alone - making the painful request for donation, removing the donor organ, returning to the recipient and carrying out the transplant, work that today is done by two entire surgical teams.
Such goriness and uncompromising emotion is, he says, inherent in what he wants to achieve artistically. "Whatever one paints, you wouldn't do it unless there was some emotional content that pleased or interested you, or that you were frightened about."
And yet in the end "one always falls short of the full story". He means in his paintings, but as he talks about the failures and disappointments, you realise that he is referring to real life and death, too. "I am still haunted by the faces of relatives and patients for whom I have not done enough," he says.
Since retiring from Cambridge in 1998 he has had few patients to paint, and in any case he is largely concentrating on sculpture, trying to capture movement in clay and stone - "because it is so difficult and so few people have done it". He does two or three kidney transplants a year in Singapore - "to keep my hand in" - operating on patients who could not otherwise afford to be treated. His new medical interest is in diabetes research, trying to get embryonic stem cells to produce insulin.
You can see that he is no longer terribly interested in transplantation: yesterday's miracle has become today's routine operation. And yet, as his former patient and Cambridge biologist Simon Stuart says, surgery will always be his true art form. "He can handle paint and canvas, paper and charcoal, but his prime medium is the human body, abdomen and guts, blood and organs. And with them, as in classical tragedy, runs a deep awareness of the proximity of death."
Sir Roy Calne
1930 Born
1959 Started research on organ transplantation
1965 Started Cambridge kidney transplant programme, now 1,600-plus cases
1968 Started first European liver transplant programme, now 1,200-plus cases
1974 Elected fellow of the Royal Society
1978 First clinical use of potent immunosuppressant cyclosporin, following lab experiments in Cambridge. Transformed survival of transplant patients
1979 First pancreas transplant in the UK
1986 Knighted
1992 First intestinal transplant in the UK