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Medicine and the Arts


Shafer, Rebecca; Shafer, Audrey MD

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doi: 10.1097/01.ACM.0000405082.52831.6f
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The cast bronze horse sculptures by Deborah Butterfield evoke a powerful sense of presence. Each sculpture is huge, about one-and-a-half times the size of a large horse. The body appears to be made of decaying driftwood, elegantly balanced such that the horse becomes a single sturdy creature. Butterfield has created a prolific portfolio of horses that are now installed across the nation. She has created so many of these statues that one has to wonder what it is that captivates her, that satisfies her artistic motives yet still drives her to continue her exploration of them. And what, likewise, captivates the viewer of these major, often public works.

In this essay we explore some of the ways in which Butterfield's sculpture is relevant to medicine. Although her oeuvre includes many horse sculptures made of found materials, we focus on the cast bronze sculpture, the most frequent form of Butterfield's horse sculptures. In particular, we examine anatomy, as expressed by the material and physical form of the sculptures, and perception, as related to some ideas evoked by the horses.

The driftwood that appears to constitute the shape of the horse is indeed where the work starts. In a process that destroys the original pieces of wood, bronze casts of individual pieces are made at the Walla Walla Foundry. Once the pieces are selected, the metal is assembled, bent, cut, and welded by the artist and her assistants. Butterfield then selects and applies a multilayered patina. The end result is metal that appears remarkably like the original wood. At the Cantor Center for the Arts, a sample piece of this bronze “wood” is on a touch-friendly display, and it is only by touching the cool metal that one truly believes it is not actually wood. Just as the metal faithfully resembles wood, the sculpture appears skeletal, yet is not. There are no anatomical correlations between the assembled units and a horse skull, vertebrae, knee joints, etc., yet the armature suggests a true skeleton. The texture of the driftwood suggests bone, but clearly is not. The fluid wood shapes are successfully representative of general parts of a horse so that the sculpture as a whole effortlessly conveys the concept of horse.

This blur of the line between what is real and what is illusion is reflected in several ways in medicine. Foremost, the introduction to medical education, namely anatomy class, is concerned primarily with distinguishing and categorizing the elements of the body. The controversy over dissection versus virtual learning reveals how important this fundamental toolkit is for physicians. In Butterfield's horses, the illusion of metal as driftwood and the nonskeletal armature emphasize the need for careful scrutiny and suggest new ways of viewing the body. Another common use of anatomical knowledge is the representation of the body in imaging for diagnostic and procedural purposes. What minimal basic structure is needed for the anatomical correlate to be recognized and perceived? How do some surgeons always know where their hands or instruments are and others require reorienting by internal landmarks? By constructing the essence of horse, Butterfield encourages reflection on what we use to identify bodies and the stuff that composes them.

The particular mood and stance of each unique horse is exceptionally subtle. The sculptures are, of course, motionless, and furthermore they are always at rest. However, there is often a sense of movement in, for example, the turn of the head. The sculptures would be completely different if the horses were midgallop or leap; rather, their lifelike state of pause holds a quiet power. The work contains a moment of encounter which fills the viewer with suspense and a sense of discovery as he or she perceives the emotional state of the horse. Just so with a patient encounter. On both sides, perceptions are formed and assumptions made. In a very short time, each individual assesses the other, and these perceptions play a critical role in care. It is a moment easily overlooked, but Butterfield teaches us to acknowledge that moment.

As physicians, we consider the patient before us in the context of all the other patients we recall, consciously or not. We use previous experience, yet we must also see the patient as unique. Similarly, Butterfield's horse sculpture is remarkable in its departure from prior Western art horse sculpture, which glorified conquest and emphasized the rider, whether European or American. The iconic Trojan horse, with its hidden soldiers, is a monumental testimony to duplicity and ruse, as well as a demonstration of horses as a means to human ends. Eschewing these well-known traditions, Butterfield instead focuses completely on the horse—perhaps following her interest in Chinese and New Guinean art.1

Butterfield's horses are ideals, yet the artist manages to include an intense individuality in each. Similarly, each physician holds a general concept of what ideal human health looks like, but it is important to remember that both health and disease manifest differently depending on the patient's life and circumstances. We are constructs of both our history and our anatomy. As we examine individual pieces of Butterfield's sculpture—the swell or swirl that indicates an eye, for example—we always remember, over and over, the work as a remarkable whole.


1 Yau J. Inside/outside. In: Gordon R. Deborah Butterfield. New York, NY: Abrams; 2003:22.
© 2011 Association of American Medical Colleges