Henry Tonks and the Faceless Boys

I have wrote in the past about how plastic surgery was originally born during the Great War as reconstructive surgery. If a soldier missing an arm or a leg was indeed a familiar figure, the introduction of new weapons during the world conflict led to the appearance of a kind of wounds precedently almost unheard of: the gueules cassées, “disfigured faces”.
Helmets were able to protect the head from granade splinters, but not the face; therefore field hospitals began to receive an unimaginable number of soldier whose faces had been blown away in large portions by the explosions.
It was an injury rarely discussed in the press, where the more iconic and patriotic image of the veteran amputee was considered more suitable, but the numbers speak for themselves: within English troops alone, 41.000 amputations were carried out, as opposed to the 60.500 men who suffered head or eye injury.
One had a higher probability of finding himself without a face rather than without legs.

Practically on every front, experimental procedures were adopted to reconstruct faces destroyed by shrapnel or burned by mustard gas.
In January 1916, at the military hospital in Aldershot, England, pioneer surgeon Harold Gillies encountered doctor Henry Tonks, who was serving as a temporary lieutenant in the Royal Army Medical Corps.

Henry Tonks was a doctor and an artist: besides being part of the Royal College of Surgeons, he also taught drawing and anatomy at the Slade Academy.

Soldiers were sent back from the front in desperate conditions, and  Tonks had the feeling that he could not handle, from a professional and humane point of view, such a catastrophe. As he himself confessed in a letter: “I have decided that I am not any use as a doctor“. And in another letter he recounted: “the wounds are horrible, and I for one will be against wars in the future, you have no right to ask men to endure such suffering. It would not matter if the wounds did well but they are practically all septic“.
And as the war progressed, things did not improve. After the Somme offensive, on July the 1st 1916, more than 2.000 patients flooded the hospital: “men without half their faces; men burned and maimed to the condition of animal“.

Thus, when Gillies asked Tonks to document his reconstructive operations by portraying the patients’ faces before and after surgery, Tonks happily accepted, as he was certainly more at ease in the artistic dimension.
To draw portraits could seem redundant, as photographs of the disfigured soldiers were already being taken, but both doctors were convinced that the cold-hearted objectiveness of film could be misleading in respect to the tactile and expressive qualities of a painting.

Thanks to his collaboration with Gillies, Henry Tonks produced a seried of facial wound portraits which still today stands unsurpassed for its emotional impact, scientific interest and subtlety of representation.
Sure, these pastel portraits had first of all a didactic intent, and the author himself did not wish them to be seen by the general public. And yet these works show a complexity that transcends their function of medical illustrations.

To understand how Tonks worked on his subjects, we have an extraordinary fortune: in some cases, the archives still have both his pastel portraits and the medical photographs. We can therefore watch, side by side, two images of the same patient, one recorded on film and the other one composed by the charcoal and colors of the artist.

Comparing Tonks’ drawings with the photographic shots, what emerges is the abstraction operated by the artist, which is meant to remove any hint at the patient’s suffering or interiority. These are accurate works, detached and at the same time compassionate, focusing mainly on the open wound, depicted with an almost “tactile” precision through the stratification of color (a consequence of the artist’s surgical training).
And yet the uncanny quality of these drawings lies in their absolutely modern ambiguity.
What could by all means be a portrait of a normal male face — ordinary traits, well-groomed hair, a knotted tie — becomes somehow “sabotaged” by the presence of the wound. It is as if our gaze, wondering over the painting’s surface, could register all these common details, just to be short-circuited the moment it meets the scandal of the injury. An inconceivable monstrosity, which appears impossible to integrate with the rest of the image.
It is then inevitable for us to fall back to the eyes of the portrayed subject, to his gaze fixed upon us, and to wonder about its impenetrable meaning.

Another peculiarity is the use of pastel, a medium considered “feminine” in respect to more virile, lively oil color or tempera; a choice that in this case allows for the lacerations of the flesh to be rendered in a softer and more tolerable way. What’s more, thanks to the lighter tone of these colors, Tonks provides his subjects with a delicate beauty and tenderness that no photograph could have ever captured.
These portraits seem as vulnerable as the mutilated youth they represent.

Suzannah Biernoff, in her wonderful essay Flesh Poems: Henry Tonks and the Art of Surgery (from which I stole most of the information for this post — you can read it in Visual Culture in Britain, n. 11, 2010) defines Henry Tonks’ works as “anti-portraits, in the sense that they stage the fragility and mutability of subjectivity rather than consolidating the self portrayed“.

Henry Tonks’ studies are set apart from classic medical illustration by virtue of this research of a particular beauty. They do not recoil from the horror they intend to portray, but cover it with a veil of elusive sensuality, in which a face becomes the sign of the uncertainty of existence, and a symbol of the cruelty Man inflicts upon himself.

Phineas Gage

Phineas Gage era un semplice operaio americano, capocantiere addetto alla costruzione di ferrovie. Era un uomo umile, affettuoso, amichevole e gentile, certo, ma poteva aspettarsi tutto… tranne che per una tragica sfortuna la sua vita cambiasse la storia.

Il 13 settembre 1848, nei pressi di Cavendish nel Vermont, Phineas stava inserendo una carica esplosiva all’interno di una roccia che andava fatta saltare per poter far passare i binari che i suoi uomini stavano costruendo. Con la sicurezza dettata dall’abitudine, Phineas stava pressando della polvere da sparo nella fenditura della roccia con un ferro di pigiatura, quando improvvisamente la polvere esplose. Il lungo palo che egli aveva in mano fu sparato verso l’altro, conficcandosi nella guancia proprio sotto all’occhio sinistro, e uscendo dalla parte superiore del cranio. Il ferro aveva trapassato i lobi frontali del suo cervello, andando poi ad atterrare 25 metri più in là.

Eppure, miracolosamente, dopo pochi minuti Phineas era già cosciente e in grado di parlare. Affrontò senza problemi il viaggio di 4 miglia fino allo studio di un dottore. Il medico, nonostante l’evidente, tremenda emorragia, non poteva credere al racconto di Gage, che insisteva nel dire che un ferro gli avesse trapassato la testa: chi poteva essere tanto fortunato da raccontare una storia simile, vivo e vegeto, e perfettamente razionale? Il medico pensò che forse era successo qualcosa di meno grave, finché Gage non si alzò per vomitare. Lo sforzo fece emergere dal foro sul cranio un pugno di materia cerebrale che cadde sul pavimento. A quel punto, era chiaro che non si trattava di un paziente sotto shock che blaterava a vanvera: una parte del cervello di Phineas era davvero stata maciullata dal trauma.

La convalescenza di Gage fu difficoltosa, passata per molto tempo in stato semi-comatoso, con risposte a monosillabi solo se interpellato direttamente. Eppure, il 7 ottobre Phineas si alzò dal letto, e meno di un mese dopo camminava già tranquillo nella piazza del paese, saliva e scendeva le scale, e si riprendeva a vista d’occhio, senza dolori o sintomi fisici preoccupanti. Ma non tutto era come prima. Il suo carattere era cambiato, si era fatto oscuro e imprevedibile.

A causa dell’incidente, Gage divenne talmente irascibile, e privo di qualsiasi freno inibitore, che nemmeno gli amici intimi potevano più riconoscerlo. Non sopportava il minimo diniego o consiglio, si lasciava andare a bestemmie e volgarità che contrastavano con il suo precedente contegno, faceva mille progetti che abbandonava minuti dopo: venne descritto come un bambino con gli istinti animaleschi di un adulto. La sua antisocialità lo portò a perdere il lavoro, e molte delle sue amicizie.


Nonostante il suo cambiamento di personalità sia stato nel corso del tempo grandemente esagerato, in molti degli scritti e degli studi a lui dedicati, Phineas Gage rimane comunque un esempio unico nel campo della neurologia, della psicologia e delle materie correlate. Gli studi sulle condizioni di Gage hanno apportato grandi cambiamenti nella comprensione clinica e scientifica delle funzioni cerebrali e della loro localizzazione nel cervello, soprattutto per quanto riguarda le emozioni e la personalità, e le diverse competenze dei due emisferi cerebrali. È anche in seguito alle riflessioni teoriche avviate in conseguenza di questo caso che, per alcuni decenni della metà del XX secolo, sono stati usati metodi, oggi in totale disuso, come la lobotomia prefrontale (già affrontata su Bizzarro Bazar, in questo articolo)  per curare certi tipi di disturbi del comportamento. Il caso Gage è ancora oggi citato e studiato ampiamente nella saggistica neurologica.

Il teschio di Gage e il bastone di ferro che ha causato il suo trauma cranico sono esposti al pubblico nel museo della Harvard Medical School. Una vita sfortunata, a cui dobbiamo la grande fortuna di conoscere meglio la struttura e le funzionalità dell’organo a tutt’oggi più misterioso, il nostro cervello.

Phineas Gage su Wikipedia (pagina inglese).