By far, the most challenging aspect of Inoculate was the self-administration of a medical procedure. Inoculate required the realization of a practice referred to as “punctal occlusion,” which I carried out myself with significant earlier preparation. Despite the individual challenge, this process was relatively straightforward. For an in-progress project titled Punctum (2017–present), I am currently attempting to create an artificial extracorporeal circuit to channel blood from an artery to a vein outside of my body. Punctum is inspired in part by German surgeon Werner Forßman’s pioneering self-experiment in cardiac catherization: in 1929, he inserted a urinary catheter into a vein in his left arm, driving this thin tube all the way to the right atrium of his heart.48 Rather than tracing the vascular system from within, Punctum proposes the externalization of blood circulation through a mirroring structure of synthetic conduits. The creation of an incision in Punctum aligns this self-experiment with the question of a surgical operation, posing a larger set of applied, conceptual, and ethical considerations which I continue to grapple with.
A strong personal influence in this regard is Forrest Bess, a U.S. abstract painter who performed genital self-surgery in 1952. Bess made an incision at the base of his penis to create a hole in his urethra, an orifice purportedly large enough to facilitate sexual penetration by another man. He completed this procedure using a razor blade and alcohol to dull the pain, as he later reported in a letter to art critic Meyer Shapiro.49 Inspired by subincision practices among Aboriginal Australians, Bess’s surgery was an attempt to physically integrate the male and female sides of himself. For Bess, hermaphroditism was a mystical path to eternal life, as well as a means to unify the conscious and unconscious psyche.50 Working as a fisherman in his father’s bait camp located on the U.S. Gulf Coast in East Matagorda Bay, Texas, Bess maintained a painting practice alongside research in anthropology, medicine, art history, religion, mythology, and psychoanalysis.51 Referring to himself as a “visionary painter,” Bess created small, dense paintings with complex visual symbolism, as well as producing a “thesis”—an extensive assemblage of images and references where he outlined his most personal concepts.
Bess mailed his thesis to scholars and medical practitioners in the United States and worldwide, including Carl Jung in Zürich and President Dwight D. Eisenhower while he was still in office. Bess also sent his thesis to Professor John Money at John Hopkins University, a psychologist and sex researcher who also received information on Bess’ initial surgery, as well as a second one performed in 1960, where he allegedly hired a local physician by the name of R. H. Jackson to expand his initial opening. Bess provided photographs that illustrated in explicit detail the operation’s results.52 In 1976, Money published an article on what would be referred today as sexual reassignment surgery, using images provided by Bess (presented anonymously) as one of his three case studies.53
The use of self-surgery for the attainment of spiritual or physical advantage also resonates with the work of Hugo Bart Huges, a Dutch research librarian and former medical student at the University of Amsterdam. In addition to holding open views on LSD and marijuana consumption, Huges was a proponent of trepanation—the surgical creation of a hole in the skull. On January 6, 1965, Huges bore an opening through his frontal bone using a foot-operated electric dentist drill54. The procedure was carried out to increase blood flow to his brain, a move that Huges believed would expand his mental capacities and compensate for the alleged decrease in cerebral circulation caused by Homo sapiens’ evolved ability to walk upright. Prior to his self-trepanation, he described his beliefs in The Mechanism of Brainbloodvolume (1962), also known as Homo Sapiens Correctus, an edition of handwritten, illustrated scrolls in English and Dutch where he identified trepanation as a way of improving brain functionality by balancing the proportion of blood and cerebral fluid.55 A decade later, Huges would self-publish The Book with a Hole: Autobiography (1972).56 This was translated by British students Amanda Fielding and Joe Mellen, who after meeting Huges became inspired to carry out trepanations of their own. Amanda Fielding recorded her trepanation in a film titled Heartbeat in the Brain (1970), while Joe Mellen would write the memoir Bore Hole (1970).57 Both are now activists advocating for scientific psychedelic research and drug policy reform.
Huges and Bess offer examples of self-surgery by individuals with specialized and non-specialized training. There are several well-known cases of self-surgery by medical professionals, such as the U.S. surgeon Evan O’Neill Kane, who removed his own appendix in 1921 (at the age of 60), only to operate his own inguinal hernia a decade later.58 Two other physicians, Leonid Rogozov from the former Soviet Union and Jerri Nielsen from the United States, also performed surgical procedures on themselves. In each case, both were the sole doctor on staff at their respective research stations in Antarctica: Rogozov removed his appendix in 1961,59 and Nielsen took a biopsy on her breast to screen for cancer in 1998.60 Yet perhaps the most striking case of self-surgery comes from Ines Ramírez Pérez, a woman from a rural village in Oaxaca, Mexico, who, with no medical background and completely unattended, successfully accomplished a cesarean section on her abdomen in 2000 that allowed both her child and herself to survive.61
The voluntary self-surgeries of Huges and Bess are far from these life-or-death cases. Even so, the surgical intervention on their own bodies is the materialization of a specific ideal or hypothesis—a motivation shared by other artists and scientists who have pursued surgery for non-vital purposes, some entailing procedures too complex to carry out alone. British artist Genesis Breyer P-orridge and French artist ORLAN have both extensively explored body modification, using transplants and plastic surgery to alter their physical appearance: the former to gain the likeness of their life partner (Pandrogeny Project, 1993–2009),62 and the latter to approximate art historical representations of the female body or to implant bulbous facial “mutations” (such as in the Reincarnation of Saint ORLAN, 1990–1993).63 The Cypriot-Australian artist Stelarc inserted a cell-cultivated ear into his arm (Ear on Arm, 2007–2015), a project in line with his previous self-experiments, such as attaching an artificial hand capable of independent motion (Third Hand, 1976–1981), and placing his body into full-scale mechatronic machines (Exoskeleton, 1999, and Muscle Machine, 2003).64 At the beginning of the twenty-first century, scientists have also started partaking in authorized and non-regulated surgery to advance medical innovation. In 1998 and 2002, British engineer Kevin Warwick introduced a silicone chip and subsequently an 100-electrode array that connected to the nerve fibres of his arm and transmitted signals to a computer.65 Likewise, Phillip R. Kennedy, an Irish neurologist based in the United States, implanted a neurotrophic electrode into his brain through a self-designed surgery in 2014 in order to develop a speech prosthesis for paraplegic or paralyzed patients.66
However, the personal decision by Bess and Huges to perform surgery on themselves is best seen through their own anatomical manifestos: Bess’ thesis and Huges’ scrolls. Both of these texts outline self-surgery as a means towards a way of life—or more directly, as an individual way of knowing. Dismissals on the grounds of pseudoscience or eccentricity do little more than reinforce the obvious inconsistency of these self-surgeries with established practices in medicine, a discipline which nonetheless, as Bess and Huges’ writings attest, remained a central point of reference well after the conclusion of their self-surgeries. The specificity of their physical transformation, even if acquired by rudimentary or even reckless means, still warrants at the very least recognition of this intention and internal coherence.
Werner Forßman was awarded the Nobel Prize in Physiology in 1956 along with André Frédéric Cournand and Dickinson W. Richards for this discovery. Prior to this, he had been dismissed from the hospital outside of Berlin where he worked due to his self-experiment, and became further marginalized in the medical community for his subsequent membership in the National Socialist Party during the Third Reich. For more information, see Werner Forßman, Experiments on Myself: Memoirs of a Surgeon in Germany (New York: St. Martin’s Press, 1974), translated from the German edition Selbstversuch: Erinnerungen eines Chirurgen (Düsseldorf: Droste-Verlag, 1972). ↩
Chuck Smith, Forrest Bess: Key to the Riddle (New York: Powerhouse Books, 2013), 67. ↩
Surviving fragments of Bess’ thesis are now held with the Meyer Shapiro papers at the Archives of American Art, Smithsonian Institution, Washington, DC, available online at https://www.aaa.si.edu/collections/items/detail/forrest-bess-thesis-13379. ↩
For digital reproductions of Forrest Bess’ paintings, visit http://www.forrestbess.org. See also the catalogue by Claire Elliot, Forrest Bess: Seeing Things Invisible (New Haven: Yale University Press, 2013). ↩
Chuck Smith, Forrest Bess, 110–111. ↩
John Money and Michael De Priest, “Three Cases of Genital Self-Surgery and Their Relationship to Transexualism,” Journal of Sex Research 12, no. 4 (1976): 283–294. Bess is described as “Case 1.” ↩
For a short film where Huges explains his trepanation (in Dutch), see Louis van Gasteren’s De Ingreep (1965). ↩
An extensive collection of materials related to Huges are available at the Gemeente Amsterdam Stadsarchief and the International Institute for Social History in Amsterdam, the Netherlands. ↩
Hugo Bart Huges, The Book with the Hole: Autobiography, trans. Joe Mellen and Amanda Fielding (Amsterdam: Foundation for Independent Thinking, 1972). ↩
See Joe Mellen, Bore Hole (London: Strange Attractor Press, 2015 ). ↩
Drummond Rennie, “Do It to Yourself Section: The Kane Surgery,” Journal of the American Medical Association 257, no. 6 (1987): 825–826. ↩
Vladislav Rogozov and Neil Bermel, “Auto-appendectomy in the Antarctic: Case Report,” British Medical Journal 399 (2009): b4965. ↩
Jerri Nielsen, Ice Bound: One Woman’s Incredible Battle for Survival at the South Pole (London: Ebury Press, 2001). ↩
Arturo Molina Sosa et al., “Self-inflicted Cesarean Section with Maternal and Fetal Survival,” International Journal of Gynecology and Obstetrics 84, no. 3 (2004): 287–290. ↩
For more information on the Pandrogeny Project, see the documentary film by Marie Losier, The Ballad of Genesis and Lady Jaye, 2012. ↩
See C. Jill O’Bryan, Carnal Art: Orlan’s Refacing (Minneapolis: University of Minnesota Press, 2005), and Simon Donger and Simon Shepherd, ORLAN: A Hybrid Body of Artworks (London: Taylor and Francis, 2010). ↩
Kevin Warwick, I, Cyborg (Champaign: University of Illinois Press, 2004). ↩
Adam Piore, “To Study the Brain, a Doctor Puts Himself Under the Knife,” MIT Technology Review, November 9, 2015, https://www.technologyreview.com/s/543246/to-study-the-brain-a-doctor-puts-himself-under-the-knife. ↩