Impact case study database

1914FACES2014 examined how the mutilated faces of soldiers injured during WWI influenced medical practice, social and political history, the arts and philosophy. In particular, it considered how the radical forms of surgery pioneered at that time owed a debt to artists and, conversely, how the cultural legacy of ‘les gueules cassées’ (the ‘broken faces’, as they became known) continues to shape our experience and perception of disfigurement.

Challenging public perceptions of disfigurement and maxillofacial surgery

Veteran Simon Weston at the Faces of Conflict exhibition at RAMM, Exeter

Two exhibitions foregrounded the debt of maxillofacial surgery to early 20th-century collaborations between surgeons and artists. A touring exhibition that visited Seale Hayne in Newton Abbot (June 5-29, 2014) and the University of Exeter Forum (February 25 to March 26, 2015) juxtaposed portraits and sculptural works made from military uniforms, while a three-month exhibition at the Royal Albert Memorial Museum (RAMM) from January-April 2015 displayed medical materials alongside portraits, collage, drawings and sculptures. Both featured a variety of public events with speakers including surgeons, poets and veteran and disfigurement campaigner Simon Weston [5.1].

Visitors’ responses to the exhibitions offer powerful evidence of impact. 63,680 visitors were asked about their perceptions of disfigurement, likely reactions to disfigurement before and after the exhibition, and the ways in which artworks can influence these perceptions. 480 gave questionnaire feedback demonstrating that the exhibitions’ impact was to challenge ‘assumptions of what a face should be/do/look like’ [5.1: #132].

Comment cards show it helped people react to disfigurements in a more considered manner. ‘ Everyone should view this exhibition,’ said one. ‘It helps us to understand and perhaps next time we see a disfigured person we will not rudely stare.’ [5.1: #8] Another said: ‘ It made me realise that it isn’t a laughing matter.’ [5.1: #112] Overall, it changed opinions on disfigurement, with an indicative response being ‘ I now have more respect for disfigured people’ [5.1: #48].

Visitors with personal involvement in reconstructive surgery [5.1: #123, #134, #139, #140, #143, #148] suggested that it was productive to hear about its history [5.1: #143] and that ‘ the techniques pioneered by Gillies and McIndoe and others [are] still being practised today’. [5.1: #134] They also noted that the exhibition showed an often-overlooked aspect of facial surgery: ‘[It] is widely believed to be a vain specialty. However 90% of plastics is reconstructive post trauma/burns/cancer. This exhibition helps to change people’s mis-held views.’ [5.1]

As well as providing insights on surgical history and practice, and eliciting a number of personal resonances, the responses illuminate two ongoing debates in our society: ways of representing war, and perceptions of beauty and disfigurement. Response 14 demonstrates visitors’ realisation of the importance of this work: ‘This should only be the beginning of a large cycle of exhibitions which should question images of “ideal faces” in the media which surround us.’ [5.1]

Significant regional media coverage attests to the high level of engagement, with pieces in the Western Morning News, Plymouth Herald, Mid Devon Gazette, BBC Spotlight, Radio Devon, ITV South West, Phonic FM and fashion blog ShowStudio. [5.2] Charity Changing Faces declared that 1914FACES2014 had ‘contributed to raising awareness of disfigurement as a social issue and led to a change in perception from people who experienced the programme’. [5.3]

Developing professional practice of educators, artists and charities

The project team consulted with UK-based charity Changing Faces, the Imperial War Museum (IWM) and a teachers’ focus group in May 2014, before creating a range of educational resources for students at Key Stage 3. Changing Faces identified the need to challenge negative and stereotypical representations of disfigurement as ‘an urgent priority’. “Perceptions are bound up with long-standing traditions of facial expression and beauty, and these are shaped by visual media including painting, photography and film.” The exhibitions and teaching materials were conceived to address the charity’s assertion that “understanding these media is key to understanding, and reconfiguring, contemporary perceptions of disfigurement”. [5.3]

The teachers’ focus group identified that PSHE often raises questions of appearance, self-image and discrimination in a general way [5.4]. In response, the PSHE materials produced offer a focused case study [5.5]. In AQA History GCSE, the topic on ‘medicine through time’ includes a sub-section on surgery in the industrial modern world, which focuses on WWII pioneering burns specialist Archibald McIndoe but doesn’t cover the key innovations of Gillies et al during/after WWI. [5.4] The resources address this, offering students insight into this important era. [5.5]

A pilot project was held with Year 8 students at Penrice Community College (St Austell, Cornwall) in 2014, followed by two sessions for Year 10 students at the University of Exeter in April 2015. Exhibition-related sessions for schools (run by Jones and Gehrhardt) involved students from King Edward Sixth College in Totnes, West Exe School in Exeter (January 2015) and St David’s School, Exeter (February 2015). A further session at RAMM was run for members of Blackdown Hills Artists and Makers by project curator Cristina Burke-Trees in February 2015 [5.6]. Additionally, a two-hour session for Exeter University of the Third Age (U3A), an organisation for retired people with formal links to the University of Exeter, took place on July 5, 2016. Presenting FACES research and discussing the ways in which non-academic audiences have engaged with it so far, it included a Q&A session focusing on perceptions of disfigurement, user reactions to exhibition materials and how perceptions can be shaped by visual media. Questionnaires from the 24 participants were evaluated in July 2017 [5.7].

For the project’s artist in residence, Paddy Hartley, the research-rich environment had deep implications for his practice: ‘Presenting in both the conferences/ workshops and in Faces of Conflict helped place and contextualise my work alongside my artistic/academic peers dealing with complementary themes relating specifically to facial injury/surgery across conflicts and generations.’ [5.7] As well as recontextualising his work in a medical humanities context, installation of the Yeo crossword at RAMM led to ‘a fundamental shift in the way in which I make artwork’, including heightened emphasis on the implications of research findings and how media and materials can produce rich engagement with histories of disfigurement [5.8], as seen in his later residency and contribution to a permanent display at the National Maritime Museum, Greenwich (2016-).

West Exe School staff created their own web page relating to Faces of Conflict, including extracts from the 1914FACES2014 Exeter website intended to stimulate discussion, both in class and in field study. These educational sessions also fed into development of Gehrhardt’s professional practice, including undergraduate teaching and outreach activities [5.6].

The collaboration represented the first time Changing Faces had been involved in working on an education programme for this age group. ‘It enabled us to understand how research can be communicated to schools, which subsequently led us to review our approach to formal education routes.’ Overall, the impact ‘enabled [us] to build our knowledge of the historic context of the area and extend our campaign for face equality using new platforms’. [5.3]

Inspiring students to interact with academic research

The Year 8 pupils in the Penrice pilot project, who were considered unlikely to achieve any GCSEs, showed a clear enthusiasm for contact with university research. Esther Oldrieve (teaching staff) noted pupils’ fascination with individuals’ stories, their willingness to contribute their own experiences and draw links to modern-day examples, and how it sparked debate within the group [5.6]. Teachers felt the human element of the lesson helped develop empathy and understanding and were keen to include similarly research-led teaching in future practice.

During the Year 10 sessions at the University of Exeter, students explored archival materials from IWM and visual sources prepared by Hartley. They discussed issues of morale, prejudice and visual representation which they said they had not previously considered. Teachers found it stimulating as it emphasised aspects not normally engaged with in class and noted the inspirational effect of academic research on the students [5.6].