Contemplating the Contemporary: Sculpture

Contemporary art is all around us, but we often still ask: “Is it art?” In the first of a new blog series exploring how and why we make art, Guillaume Vandame looks at sculpture in our Medicine Now gallery and beyond for Contemplating the Contemporary.

Contemporary art of the twenty-first century is driven in part by advancements and innovations in the practice of sculpture. In particular, artists are interested in using mixed media, found objects and ready-mades, triumphed by artists such as Robert Rauschenberg and Marcel Duchamp, and at the same time, developing highly sophisticated forms of fabrication, as exemplified by Jeff Koons, Damien Hirst and Takashi Murakami. These contemporary strategies to making sculpture are continued with some of the artists featured in the Medicine Now gallery. Click each image for more information.

Robert Rauschenberg, Canyon. 1959. (© 2014 Robert Rauschenberg Foundation/Licensed by VAGA, New York, NY)

Marcel Duchamp, Bicycle Wheel. 1951. (© 2014 Artists Rights Society (ARS), New York / ADAGP, Paris / Estate of Marcel Duchamp)

Jeff Koons, Pink Panther. 1988. (© 2014 Jeff Koons)

Takashi Murakami, Fire sculpture. 2013. (© 2013 Takashi Murakami / Kaikai Kiki Co., Ltd. All Rights Reserved.)

Damien Hirst, Mother and Child (Divided). 1993-2007. (© Damien Hirst and Science Ltd.)

In the first space in Medicine Now, on the theme of Obesity and Genetics, there are two sculptures produced by John Isaacs and Rob Kesseler. Isaacs’ sculpture is striking and one of the first works visitors recognise in the gallery. I Can’t Help the Way I Feel was produced in 2004 and made predominantly from wax. Wax and wax-like materials such as fibreglass plastic have been investigated by a range of contemporary artists from Duane Hanson to Ron Mueck, predominantly in the pursuit of hyperrealism and strange, uncanny representations of the body.

John Isaacs, I Can Not Help The Way I Feel. 2003. (Courtesy of Wellcome Collection, London.)

Duane Hanson, Man on Mower. 1995. (© Estate of Duane Hanson/Licensed by VAGA/New York, NY)

Ron Mueck, A Girl. 2006. (© National Gallery of Canada.)

Despite its popularity as a material, this is not your typical wax sculpture of a famous celebrity you would find at Madame Tussaud’s. John Isaacs’s sculpture, in effect, could represent anyone and, at the same time, serves as an allegory of obesity; the ultimate visualisation of excessive consumption, corpulence and greed. The sculpture is pulsating and visceral, a quality which Isaacs exaggerates and seizes as an opportunity to strike our imagination about the possibilities of obesity. Perhaps the most terrifying aspect represented through its amorphous curves and folds is the anonymity of such a sculpture which could at once appear realistic and unknown. In this way, Isaacs presents a subject which is less about itself and more about our own critical reception and attitudes towards body image and its relationship to space.

Shown together with Kesseler’s, Bud, from 2002, the two sculptures deliberate ideas of consumption and the body. In contrast to Isaacs, who is much more hands on and appreciates the materiality and humanity of sculpture, Kessler presents a sculpture with no trace of his body and emphasises the sophisticated processes of creating new media through its fabrication.

Rob Kesseler, Bud. 2002. (Courtesy of the artist and Wellcome Collection, London.)

The sculpture is a glass vessel, shaped like a wine glass, missile or trophy, and filled with genetically modified soy beans. Kessler’s exploration of genetic modification considers some of the multifaceted positions surrounding the subject.

On one level, there are the unknown consequences of genetic modification. In particular, there is the concern that genetically modified foods could adversely affect our health while having an unforeseen impact on the environment. On another level, there are the obvious advantages of genetic modification: accelerated food production could yield a surplus which could eradicate hunger and world poverty.

Kesseler’s slickness and austere minimalism is used to great effect with this work of art and is a characteristic which follows some of the other key works in Medicine Now, including sculptures by Mauro Peruchetti, Annie Cattrell and Luke Jerram. The act of reducing an object to its most basic form is used to demonstrate the spiritual essence or physicality of a work of art, as spearheaded with modernist masters such as Donald Judd, Carl Andre and Richard Serra. In other cases it is used to emphasise ideas of industrialisation, consumerism and mechanical reproduction, exemplified by the gaudy, oversized sculptures of cheeseburgers, ice cream and cake by Claes Oldenburg, comparable to Peruchetti’s series of deliciously coloured  jelly babies made from polyurethane. Everyday life, through both subject matter and material, thus becomes a central focus of contemporary sculpture displayed in Medicine Now and remains an integral aspect of international artists working today.

Annie Cattrell, SENSE. 2001-2003. (Courtesy of the artist and Wellcome Collection, London.)

Donald Judd, Untitled (Stack). 1967. (© Helen Acheson Bequest (by exchange) and gift of Joseph Helman)

Luke Jerram, Swine Flu Virus (H1N1). (Courtesy of the artist and Wellcome Collection, London.)

Mauro Perucchetti, Jelly Baby 3. 2004. (Courtesy of the artist and Wellcome Collection, London.)

Claes Oldenburg, Floor Cake. 1962. (© 2014 Claes Oldenburg.)

Guillaume is a Visitor Experience Assistant at Wellcome Collection.

Perspectives: I can’t help the way I feel

We are fascinated by the photographs our visitors take of the objects and spaces within Wellcome Collection. Thanks to Instagram, we can not only see what’s eye catching but also how people view us and our material. Charlie Morgan and Russell Dornan explore one of the most photographed objects with a little help from the public.

Wellcome Collection Instagram

Visitors who enter our gallery Medicine Now are unlikely to miss I can’t help the way I feel.  The John Isaacs artwork is by far the biggest object in the space, but is also the most eye-catching. Initial responses regularly range from shock to horror and are often followed by an assumption that this must either be based upon a real person or instead be a warning of what could happen if obesity were left unchecked. However, the name of the piece indicates that Isaacs is putting across a far more nuanced point.

In the first case this could never be a real person. The wax sculpture may be in human form but it lacks arms, genitalia and a head: the last of which any human being would need to survive. But the lack of these parts also strips the figure of all identifying features and any kind of individuality. All that remains is an ever expanding mass of tumorous fat. As such, far from being a realistic representation of what someone could be, the piece is instead a depiction of how people could, and do, feel. I can’t help the way I feel reflects what Isaacs calls the ‘emotional landscape’ of someone who might glance in the mirror and see themselves in a certain way when in reality they look nothing of the sort. So it’s a piece about obesity, but it’s equally a piece about anorexia and about body dysmorphia; it’s about the personal implications of a society obsessed with an ‘obesity epidemic’ and with body image.

A selection of photographs taken by the public and uploaded to Instagram of the John Isaacs sculpture "I can't help the way I feel". Click through to see the full gallery.

A selection of photographs taken by the public and uploaded to Instagram of the John Isaacs sculpture “I can’t help the way I feel”. Click through to see the full gallery.

Of course, it’s also an outstanding work of art and a fantastic photo opportunity for Wellcome Collection visitors; it is one of our most photographed objects. Since the sculpture challenges its viewers to see things in new ways it lends itself to being scrutinised from many angles. En masse photos of the same object may force you to notice small details, look harder and generally see it differently. The photographs above are all from Instagram courtesy of the curious public. Click on the image to see the gallery in full and witness the different perspectives (as well as many similar ones) offered by visitors to the gallery. Next time you’re in Medicine Now why not take one yourself? Remember to tag it #WellcomeCollection or #wayIfeel if sharing on Instagram or Twitter and let us know how it makes you feel.

Charlie Morgan is a Visitor Services Assistant at Wellcome Collection and Russell Dornan is the Web Editor at Wellcome Collection.

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Object of the month: Eat 22 (An interview with Ellie Harrison)

For one year and one day, commencing on her 22nd birthday on 11 March 2001 and ending on her 23rd, Ellie Harrison photographed everything that she ate. The resulting film and book entitled Eat 22 can currently be seen in Medicine Now. Nearly 12 years after the project was completed, Charlie Morgan spoke to her for Object of the Month.

Ellie Harrison, Eat 22

Ellie Harrison, Eat 22

Ellie Harrison has always been interested in food. When she created Eat 22 it was the first of a wider series of ‘data collecting’ projects in which she painstakingly recorded details of her own life. In 2006 Ellie officially quit data collecting and instead of looking inwards at herself began to use art to look out at “what was going on in wider political and social systems”. Yet despite this she is still drawn back to food as a subject matter. In 2009 she produced Vending Machine, a normal machine reprogrammed to only release crisps when news of the recession came up on the BBC News RSS feed. Through projects like this she is attempting to create a “direct link between wider economic and political events and our food supply” and to examine “the absurd consequences of the capitalist system” of which “the obesity epidemic is one and climate change is another”. It was in the context of this change in approach that I spoke to Ellie about her enduring interest in food.

Charlie Morgan: In Medicine Now, Eat 22 is in a section about obesity, and I know obesity and our relationship to food is something you are interested in now. At the time did you actually think about it in those terms?

Ellie Harrison: No I wasn’t really; it’s funny actually because when I came to the launch at the Wellcome Collection in 2007 I just found it hilarious that my piece of work was right behind the John Isaacs thing. I had never really thought about that piece in relation to obesity, I don’t know whether I took offence at the fact that it had been bunged in the obesity section, I might have done actually at the time! But now I think it makes perfect sense, and actually I’ve just made a film for a project I did called The Other Forecast in which I’m wearing a fat suit because I’m talking about increased rates of obesity.

CM: One thing that I always find interesting is that when people read through the book of Eat 22 they are in a sense just looking at pictures of you eating food, but they also quickly learn quite a lot about where you’re studying, where your family live, where you work and so forth. You produced the book in a sort of diary format but what were your thoughts behind providing that additional information, did you ever think that someone could look through it and piece together bits of your life?

EH: I just wanted to be as thorough as possible when I was doing it, but I guess I always have a sick fantasy that people might look it and piece together bits of my life! I think everybody has that same sick fantasy now; everybody’s publishing information online, everybody sort of hopes that people will be interested in the minutiae of their everyday lives. But I think I was really unconscious of all of that when I was doing it because I was so young and it’s only in hindsight that I’ve thought more about the process of making this private information public and why you would want to do that. I’ve thought about what it might mean perhaps in terms of an attempt for some sort of immortality through documenting something that will live on longer than you do, I mean that’s probably one of the reasons why a lot of artists make work.

I never knew it was going to end up in the Wellcome Collection and I never knew it was going to make the impact that it did. It just seemed to strike a chord with people all over the world who were able to identify with it and it really sort of snowballed in terms of the press coverage that it got. It’s quite weird thinking back on it now because I was a different person then and when I look back at my life, yeah, you can extract all of that information about what I was like then, but I guess I’m quite different now.

CM: You’ve said now you think of yourself as quite young when you produced Eat 22, do you think it was a product of your age?

EH: It was definitely a product of my age but also of technology. I was at university and I learnt how to do basic web design, and also digital cameras were just being released around then. I got one of the earliest digital cameras which was a 0.8 megapixel camera and it seems really backward now, but if it hadn’t have been for those developments in technology I don’t think it would have been possible.

At the time I was a student learning about the internet and it just seemed such an amazing tool for an artist. It was really liberating to be able to communicate directly with an audience in a way that just wasn’t possible before. As an artist working in a more traditional field your fate is in the hands of exhibition curators, critics and others who choose what to show, and I just saw the internet as an amazing tool to bypass all of that, a really democratic way of getting information out.

I was really inspired by that and had all of those things not come together at the same point in my life then it may not have happened.

CM: Just going back to something that you mentioned before when you spoke about the interest in Eat 22 snowballing, did you ever get replies from people doing the same sort of project?

EH: A little bit, on the website there’s a links page to other projects that were happening around the same time. I became aware of other people who were doing similar things and I remember corresponding with quite a lot of them. We had a sort of shared experience because it does have such an impact on your life. It did dramatically change my eating habits and I felt really restricted all the time because I couldn’t go anywhere without the camera. People ask me if I ever cared about what I would eat because it would look bad and that wasn’t ever a concern. It was more a concern with the amount of work involved in processing all the images: that was the biggest thing that was likely to deter me from eating. Everything I ate was more work!

CM: The concerns you had (or didn’t have) lead on to comments we often hear in Medicine Now. Sometimes when people visit the gallery and read Eat 22 they can be quite judgemental about what you eat: the amount you eat, whether or not they think it’s healthy. At the time did you ever become judgemental about yourself?

EH: I never really thought about that at all. I went into it thinking that I could produce a realistic picture of everything that I’d eaten, but it did end up changing what I ate. I think I did have a worse diet then than I have now: because I was a dirty student for half of it! I was eating Pot Noodles, I was eating ice creams and packets of crisps and I never really eat stuff like that now. I think I had a faster metabolism back then!

CM: With regards to eating habits – and this is probably the question we get asked the most in Medicine Now – to what extent did Eat 22 affect your eating habits after the project had finished?

EH: Afterwards, because it was such a novelty to be free and not to be being watched the whole time, I did eat more than I should have done. I think it probably takes about a year to recover, to just go back to normal and to remember what normal is. I wouldn’t recommend it as a diet!

It is useful for creating awareness of what you’re eating and nutritionists do recommend food diaries. But I was reading a blog post today about fad diets and how you can get really into them and they can really work for a short space of time but then there’s always going to be a backlash when you stop, and I think it would be unsustainable to try to attempt to do something like that for ever. It’s always going to end somewhere and there’s always going to be some sort of backlash.

CM: Finally, how did people around you react? Did you end up damaging any friendships as a result of the project?

EH: Not really because it didn’t really impact on other people’s lives in such a massive way. My friends and family took some of the photos but I developed a way of taking a lot of the photos myself.

CM: The original selfies.

EH: Yeah, the original selfies exactly. I discovered that if I turned a pint glass upside down and then I balanced the camera on top of the pint glass I could take a picture of myself on the timer very easily. I probably did a lot more than half of them that way, so I think for everybody else involved it still remained a relative novelty.

Ellie Harrison is currently running the Bring Back British Rail campaign and working on a number of artistic projects. She can be contacted through her website.

Charlie Morgan is a Visitor Services Assistant at Wellcome Collection.

What would Jesus eat?

For some, Christmas is about celebrating the birth of Jesus Christ; for others, it’s about eating as much food as possible. This month Charlie Morgan looks at a book that manages to combine both.

Angels serve Christ with food after his ordeal in the wilderness

Angels serve Christ with food after his ordeal in the wilderness

Among the many diet books in Medicine Now you can find one called Slim for Him. Often misconstrued as a 1950s ‘lose weight for your husband’ tract, the ‘Him’ of the title actually refers to God – and this is just one of a series of Christian diet books on display in the gallery. As the ever-expanding (no pun intended) weight loss industry collides with a history of religious dietary laws, publications such as God’s Answer to Fat and The Bible Diet (to name just two) are the inevitable result, but what do they actually say? More to the point, what can a religious diet offer that a secular one cannot? To find out, I decided to have a closer look at two of them.

Probably the most eye-catching Christian diet book in Medicine Now is the outrageously titled What Would Jesus Eat? The book starts with the proposition that ‘If you truly want to follow Jesus in every area of your life, you cannot ignore your eating habits,’ and as a Christian you would find it hard to disagree with that. It then proceeds to create a diet around what a historical Jesus Christ may have eaten at the start of the Common Era and, accordingly, the end result is far more archaeological than it is theological. Although recent studies have suggested that the Last Supper might have included delicacies such as grilled eels and orange slices, What Would Jesus Eat? sticks to a modern day ‘Mediterranean’ lifestyle and relies heavily on food such as pomegranates, fish and olive oil. Considering our traditional understandings of first century Galilean Jews, this is hardly surprising. Also unsurprising is the diet’s heavy reliance on bread.

Bread plays a large part in Christian doctrine, both literally and metaphorically. Jesus famously fed five thousand people with nothing but bread and fish, and modern Christians still regularly implore the Lord to ‘give us today our daily bread’. In What Would Jesus Eat? it’s a key foodstuff, and the author Don Colbert writes that not only did it have an ‘important role in the life and teachings of Jesus’ but also ‘Jesus knew that bread was the staple of man’s physical life’. Colbert is critical of some of today’s ‘baker’s loaves’ and suggests Jesus would have eaten something more similar to pitta bread, but overall he gives it positive coverage. When, however, we take a look at another book on display – God’s Diet – we begin to see an element of controversy.

God’s Diet is a very different book to What Would Jesus Eat? As opposed to taking its starting point as somewhere around the start of the Common Era, it goes much further back and bases its recommendations on which foods may or may not have been in the Garden of Eden. Clearly, this very problematic, but it immediately becomes more suspect when the author starts referring to the use of electric whisks and fridges – modern appliances that almost certainly would not have been in any sort of Garden of Eden. It also makes a number of historically incorrect assertions; for example, the book prominently claims that none of our ancestors ever died of clogged arteries, but recent excavations of mummies have revealed that they did indeed suffer from this exact ailment.

Returning to types of food, where God’s Diet notably differs from What Would Jesus Eat? is that it strictly prohibits the consumption of bread. The author states that ‘I bet [Adam and Eve] didn’t bake nicely crusted bread’ and on a list of ‘FOODS YOU CAN’T HAVE’ alongside candy, marshmallows and sweet pickles you can find, in capitalised letters, bread. In one quick move, bread has gone from being portrayed as a food that Jesus almost certainly ate (and so one that we definitely should) to one that Adam and Eve would never touch (and so one that we should also avoid). When one book asks ‘why not [follow Jesus] in our eating habits?’ and the other ‘why not eat just what God provided for us?’ yet neither can agree on where these intersect, the diet-conscious Christian is left in an awkward position.

Using just this one example, the upshot is that ultimately Christian diet books are as varied, confusing and dubious as their secular counterparts. Despite their apparent foundation in religious law, they appear to be much more a product of human desires than of divine rule. God’s Diet’s may continually repeat the mantra that ‘IF GOD DIDN’T MAKE IT, DON’T EAT IT’, but you have to wonder whether the author would still stick to this single rule if it could be somehow proven that Adam and Eve (and, of course, Lilith) ate Big Macs and Snickers Pie in the Garden of Eden. There is then little to suggest that those that live by Christian diet books are doing it for different reasons to those who adhere to Atkins or Cabbage Soup. Furthermore, there is even less to suggest that those writing them are basing them on anything other than widespread assumptions.

So our books might not reach the same conclusions on which diet works best but I think we can all agree that the holiday period really isn’t the time to be worrying about bread. Whatever Christmas means to you, make sure you enjoy some delicious food.

Charlie Morgan is a Visitor Services Assistant at Wellcome Collection.

Object of the Month: A Fat Lot of Good

I Can't Help the Way I Feel', John Isaacs (2003)

'I Can't Help the Way I Feel', John Isaacs (2003)

One of the overarching themes of our permanent gallery Medicine Now is the lived experience of illness. Juxtaposed with objects from clinical medicine, such as pills, anatomical models and teaching aids, are a broad selection of contemporary artworks that invite visitors to consider illness and disease from the viewpoint of patients…

Phantom limbs, colour blindness, dyslexia and multiple sclerosis: these are just some of the many conditions explored by artworks in Medicine Now. But of all the fascinating and thought-provoking pieces on display, by far the most imposing is ‘I Can’t Help the Way I Feel’, by the British artist John Isaacs. A huge, amorphous blob of realistic-looking human fat, complete with hideously swollen legs and blotchy, irritable sores, the sculpture is John Isaacs’ take on the ‘obesity epidemic’ sweeping the developed world, and the reductive, depersonalising dimensions of the worst of clinical medicine.

To say the artwork is huge is an understatement. When it was first installed, all the way back in 2007 when Wellcome Collection first opened its doors to the public (is it only four years ago?!), it was so big it couldn’t fit through the gallery doors, and our curatorial team had to winch it, angel-like, up through the space by the spiral staircase – a bizarre sight, if there ever was one. The artwork tells the story of obesity from the viewpoint of the patient. It represents a living person whose defining features, gender, personal story – in short, everything that makes them unique as an individual – has been systematically removed by an explosion of fat, engulfing the head, the arms, and everything in between. Cleverly sculpted from polystyrene and painted wax, it is so terrifyingly realistic that many visitors mistakenly believe it is a representation of a real-life person, or a very serious genetic disorder. Anything but – it represents plain and simple obesity, albeit obesity that has been taken to the extreme by John Isaacs.

The artwork has a serious point to make. Isaacs is interested in the lived experience of disease – the ‘emotional landscape’ of the individual – and its tense relationship with society. The sculpture doesn’t represent obesity in a real, physical sense, the kind of obesity that presents itself to clinicians or members of the public. It is a literal embodiment of obesity in a highly idealised, abstract form. It represents the feelings of those who live with and confront obesity, and how these feelings are defined in response to social ideals and expectations. It graphically represents what would happen if, somehow, these emotions were to manifest themselves physically, on the surface.

John Isaacs has thus privileged the subjective over the objective dimensions of obesity, and has helped redeem it from the reductive potential of clinical medicine, which, at its extreme, can reduce obesity to merely a set of symptoms, or another set of depressing statistics in the news. The thoughts, feelings and fears of those who live with obesity are often absent from such a presentation of obesity. At its worst, they are discounted altogether. It is easy to see why people can become defined, stigmatised, or even trapped by their condition, if the ways in which they can express their experiences and feelings are so heavily conditioned by the society in which they live – what Isaacs refers to as the ‘emotional landscape’. They really can’t help the way they feel. The most literal example I can think of is the stock footage of obesity you see on the news, when they are ‘objectively’ reporting on the latest comments made by a health expert. You almost never see faces, personal stories, or anything else that identify these people as individuals who are anything other than ‘obese’. All you see is beheaded waistlines and random flashes of disembodied mouths eating hamburgers. Sure, the news has a duty to respect the privacy of the people they are reporting on, which is why these faces are absent in the first place. But a consequence of this is that people become objectified, anonymised, and their personal circumstances and stories are pushed under the surface.

In recent years, campaigners such as Vicki Swinden, founder of the ‘Fat is the New Black’ campaign, have tried to reduce the level of stigma surrounding obesity by re-appropriating the label of ‘fat’ – transforming it, as it were, into a fashion label. The logic behind the campaign is that by giving people the freedom and confidence to express themselves, they are more likely to participate as active members of society, and be physically active as a result. In an age where two thirds of British adults are overweight and where almost a quarter are clinically obese, could it be the case that focussing on the subjective, emotive and psychological elements of obesity has genuine, positive public health benefits?

Hijacking natural systems

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The human body is an amazing thing, and there are some amazing things to be done with cells from the human body.

The images above show how live cells being used in world-leading research and taken from microscope images and live cell signalling can be manipulated into a variety of shapes, drawings and animations.

The process has been a long and exhaustive one and has involved the artist, Jo Berry, moving into unchartered territories as an undergraduate research student for six months, working with cutting edge technology on research that scientists hope will help sufferers of conditions such as diabetes and obesity.

The process included interpreting microscope images and live cell signalling to find out more about how drugs work within individual cells.

The research, being carried out at the Nottingham University School of Biomedical Sciences, involves assessing how the hunger hormone ghrelin stimulates human cells, potentially paving the way for new drug treatments for obesity and diabetes by “turning on and off hunger”.

Those images were taken by Berry back to her studio in Carsington, Derbyshire, and she manipulated them to create a series of short films, vinyl drawing and multi-layered lightboxes.

The crossover between art and science and the process involved in evidence-gathering was the main draw for Berry, with the work being assisted by grants from the Wellcome Trust and Arts Council England.

“It’s about the process of working in a facility where they are doing such important research, and taking that research, its software and imagery to create something cutting edge and entirely different has been incredible,” she said.

“I was able to play about with colour, cutting and pasting, speeding up and slowing down films, making stereo images and looking at cells from different three-dimensional views – taking the science and software and approaching it from a different angle.

“The project is celebrating the human body, the use of new technology, the collaboration between science and art, and also gives the public the opportunity to see art in a non-traditional setting.

“The hormone we studied is in us all, helping us decide when to eat, so the inspiration behind the work is part of everyone. I really want people who do not usually go to art galleries to come along and enjoy what they see, and see how exciting putting science and art together can be.”

The project, called Hijacking Natural Systems, goes on show in Derby from July 2011, before moving to Nottingham.

Hijacking Natural Systems was funded in part by a Wellcome Trust Arts Award. More details of Jo and her work can be found at www.joberry.co.uk and www.joberry-artist.blogspot.com.

Solutions for a sick city

Solutions for a sick city?

Solutions for a sick city?

London played a very important role in the history of hot air ballooning, but when we gather at Wellcome Collection for a balloon debate, it’s not to extol or denigrate the virtues of this early form of human flight. Rather, we take an important problem, invite four speakers to each put the case for one solution or priority, and then allow the audience to vote them out, one by one, of an imaginary balloon which is losing height, leaving one victor at last.

Last week, the issue was public health priorities for London. During the week, on this very blog, each speaker had been given a chance to make their point, On Thursday night, the four came together, chaired by the BBC’s Home Editor, Mark Easton, to put their case to a live audience. Each speaker was given just ten minutes to get the facts and their argument across.

Round one

In the first round, Paul Farmer, chief executive of Mind, supported the case for putting mental health first, an invisible but widespread problem that underlies other health issues. Over 30 per cent of London residents have experienced mental disorders, 19 per cent have had suicidal thoughts and 11 per cent have attempted suicide. More time is lost at work through mental health issues than through musculoskeletal disorders. Worse, 90 per cent of people with mental health problems have encountered stigma and discrimination at work and in society at large. Mental health needs to be at the centre of a virtuous circle of changing attitudes, Paul argued.

Bobbie Jacobson argued for taking on child poverty. We all were children once, and 56 per cent of London’s children today are prevented from living a full participative life due to poverty. Even the richest London borough is without pockets of abject poverty. Any map of health problems is a map structured by an underlying map of poverty. Merely raising awareness of the problem without suggesting a solution is pointless, argued Bobbie. Her solution is the London Living Wage, a London-specific minimum wage of £7.85/hour, which takes into account the higher cost of living in London. There are half a million businesses in London, and all of them need to pay the London living wage.

Ajit Lalvani made the case for tackling tuberculosis, a medieval scourge that many might be surprised to find on the agenda. TB was the only threat presented to the audience that is an infectious disease. We might think of ourselves as beyond the age of cholera, but SARS, also a respiratory disease, caused 2 million deaths among 9m cases worldwide in its recent outbreak. London is the only western European capital with rising rates of TB, which is acquiring drug resistance and can kill in as little as 16 days. Latent TB, which can show no symptoms, is a silent killer – the full scale of which is unknown.

Finally, Alan Maryon-Davis proposed childhood obesity as London’s biggest health challenge. At current rates, by 2025, half the male population of London will be clinically obese. Overweight children are not only subject to teasing and low achievement at school, but massively increase their risk of ill-health from heart disease, diabetes and cancer, reducing their life expectancy by the same amount as smoking. In order to avoid a generation of children dying younger than their parents, we need to promote both healthy physical activity and better awareness of healthy cooking. Southwark, for example takes local kids to Borough market to learn about fresh food.

Such groundbreaking activity cut no ice with the audience. They raised their green cards and voted Alan out of the balloon. The remaining three speakers were then given four minutes each to develop and expand their position.

Round two

Ajit then outlined a course of action to fight TB: an outreach programme of mobile chest x-ray units to target the poor and homeless, who are most at risk. Improved tests on sputum can detect latent TB at much improved rates. These new diagnostic tools are already at risk from cuts and have to be saved.

Bobbie argued that Paul’s proposal offered no strategy for dealing with mental health, and that previous efforts to fight TB had been successful primarily because they housed and fed the homeless. She admitted that the London Living Wage couldn’t solve the problem of workless poverty, but rather would kick-start a bigger fight.

Paul argued that there were indeed concrete solutions for mental health. Mind’s Time to change campaign tackled stigma, working with teachers who are at the sharp end of fighting discrimination, and achieved improvements in public attitudes with very little public money. He questioned whether poverty was really a public health issue at all.

The final round

Mercilessly, the audience raised their cards, and voted Ajit and TB out of the balloon, leaving mental health and child poverty in the final face off. Bobbie read from an Evening Standard article by David Cohen, which describes burying the children of London’s poor in unmarked communal graves. Paul offered his respect for the fight against child poverty, but argued that ultimately it wasn’t a public health issue; the opportunity to make London a happier, and therefore, healthier place was unmisssable.

Before the audience got their chance to put questions directly to the remaining panellists, Alan and Ajit were asked who they would vote for: both plumped for mental health.

From the floor, Paul and Bobbie were asked what measurable improvements they could offer against their challenge. Bobbie answered with a reduction of a third in child poverty; Paul suggested a 10% shift in attitudes towards mental health. Another questioner wondered to what extent solution for London could be a blueprint for other cities. Paul answered that in fact much of Mind’s campaigning has been inspired by a similar effort in New Zealand; Bobbie suggested that we could, in fact, look to other countries like Cuba, where equality and healthcare are taken much more seriously. The question of whether small businesses could afford the London Living Wage was also raised; Bobbie answered that, as with elsewhere in the world, it was possible.

The audience was asked to choose one final time, between the state of poverty and the state of mind. Your humble blogger, who can now reveal that he was voting for Bobbie and child poverty down the line, had suspected throughout that it would come down to these two, and felt sure child poverty had an unanswerable case.

It did not, and the audience ultimately decided that mental health was London’s number one public health priority.

If you’re inspired by the audience’s decision, why not get involved with Mind, and start changing attitudes? If you disagree, the comments thread below is open for your thoughts. On this blog  we’ve enjoyed playing host to an interesting and vital debate, but now it’s over to you.