The Garnett Passe and Rodney Williams Foundation, a major medical research foundation in Melbourne, has recently acquired a painting of a tonsillectomy (Fig. 1) by Dame Barbara Hepworth. This hitherto unknown and uncatalogued painting by the celebrated British sculptor and artist is of the Foundation's nominal patron Garnett Passe performing a tonsillectomy, probably at the London Clinic, in 1948.
The Tonsillectomy by Dame Barbara Hepworth. © Bowness Hepworth Estate.
In the 1940s, Barbara Hepworth met two surgeons, Norman Capener (an orthopaedic surgeon practising in Exeter) and Garnett Passe (a London ENT surgeon), and in 1947 was invited to their hospitals to view them operating. She first met Norman Capener in 1943 when her daughter Sarah, one of triplets, developed osteomyelitis of the leg requiring treatment at the Princess Elizabeth Orthopaedic Centre in Exeter. From 1947 to 1949, Hepworth made frequent visits to both surgeons' hospitals. Her initial chance meeting sparked one of the most remarkable series of surgical paintings and drawings ever produced in Western art.
Barbara Hepworth was born in Wakefield, Yorkshire, in 1903 and later studied sculpture at the Royal College of Art in London. She was a student with Henry Moore, and the two became colleagues and friends for the rest of their lives. They were rivals but, working and stimulating each other with similar artistic concepts, they forged a new direction for twentieth century sculpture in Britain.
Norman Capener had a professional attachment to the London Clinic in Harley Street and made frequent visits to it from Exeter to stay in touch with his colleagues. It was there that he was introduced to Garnett Passe.
Edward Roland Garnett Passe was an Australian ENT surgeon practising in London. He graduated from the University of Melbourne as a dentist but travelled to London in 1926 and finished a medical degree there. He became an ENT surgeon in the late 1920s and early 1930s and developed an early fascination with the surgery of deafness, and particularly with otosclerosis. Garnett Passe went on to develop a considerable name for himself whilst popularising and advancing Julius Lempert's one-stage fenestration procedure as a treatment for this condition.
During their early meeting in 1947, Garnett Passe invited Hepworth to his operating theatre to view him performing this surgery, and this gave rise to the surgical paintings and drawings known as the Fenestration Series. There are six fenestration paintings and a notebook, held by the Science Museum in London, which contains 28 sketches and drawings. There is an excellent description of the Fenestration Series of paintings in the late John Booth's article ‘Window on the ear. Barbara Hepworth and the Fenestration Series of drawings’.Reference Booth1
The details surrounding the painting of The Tonsillectomy are unknown. The Barbara Hepworth Estate had held the painting for many years, and it came to the Foundation directly from the Estate.
The Dame Barbara Hepworth Estate, based in London, manages her legacy and promotes her name and artworks. The current director and trustee is Sir Alan Bowness, art historian, former professor of Art History at the Courtauld Institute, past director of the Tate Gallery in London and director of the Henry Moore Foundation. He married Sarah, the eldest triplet of Dame Barbara Hepworth, who had contracted osteomyelitis of the leg, thus initiating this whole intriguing story.
The Garnett Passe and Rodney Williams Foundation was initiated and funded by Garnett Passe's widow Barbara Williams. Garnett Passe died suddenly in 1952 at the early age of 48. His widow Barbara, at 43 years of age, was left in comfortable circumstances with a house in central London and a good income. This allowed her to mix in sophisticated London society, where eventually she met Rodney Williams, a fifth generation, wealthy New York stockbroker who was visiting London to attend the grouse shooting season in Scotland. They later married and settled in Charleston, South Carolina, in wealthy circumstances. Rodney Williams died in 1984 and left much of his fortune to his widow Barbara.
Barbara had always had the idea to found a charitable trust to honour her two husbands. This would be dedicated to otolaryngology in Australasia, for scientific and educational purposes. The trust was established in the early 1990s. Since then funding has been applied to the creation of new university chairs of otolaryngology, to a vast amount of research (including cancer research), to the funding of various projects that have assisted the development of cochlear implantation in Melbourne, and to the training of the next generation of Australian academic otolaryngologists. It is the largest private bequest ever made to Australian medicine.
The work entitled The Mouth Operation or The Tonsillectomy was painted in 1948 using oil and pencil on canvas, and is similar to the size of the other surgical paintings, measuring 50 × 60 cm. Sir Alan Bowness has confirmed that it depicts Garnett Passe performing tonsillectomy surgery. There are four figures in the image: the surgeon Garnett Passe, the patient and two masked nursing assistants.
The assisting nurse in the Fenestration Series of paintings has been identified by John BoothReference Booth1 as Margaret Moir, and the nurse in The Tonsillectomy has the same facial characteristics of sharp, pointy features and almond shaped eyes. However, in photograph 12A on page 10 of Booth's article, she is seen wearing spectacles. The assisting nurse in all of the Fenestration paintings and sketches, as well as in The Tonsillectomy, is depicted without glasses.
Margaret Moir later moved to Cornwall after Garnett Passe's death and became a general factotum to Lily McDonald, the widow of Duncan McDonald, who was a director of the Le Fevre Gallery in London where Barbara Hepworth's surgical series of paintings were exhibited. This move was also, of course, close to the home of Barbara Hepworth, whom she would have known well by this stage.
In The Tonsillectomy, Garnett Passe appears to be wearing a head mirror rather than a headlight. The mirror has a toggle, presumably for adjustment, on its lower border, or it could possibly be a light bulb. A review of the surgical catalogues of the time has failed to identify it.
Garnett Passe is looking into the pharynx of the patient, who is in the tonsillectomy position. There is no visible anaesthetic tube nor obvious Boyle–Davis gag, but presumably one is in place as the patient's mouth appears widely open. It is very unlikely that the operation is being performed under local anaesthetic, with the patient in this supine position with hyperextension of the head. If a Boyle–Davis gag is in place, albeit only loosely sketched in, then there may be an anaesthetic tube attached to the tongue depressor part of the gag, delivering gases to the pharynx out of sight on the patient's left-hand side. Alternatively, it is possible that a general anaesthetic utilising a mask and chloroform, or similar agent, is being used.
There does appear to be a mechanical arm coming up from the region of the patient's chest with a right-angled extension, which is an obsolete method of fixing the gag now superseded by the use of Draffin rods. Details may have been omitted for the sake of clarity of the image. There is no sign of a guillotine so presumably the tonsil dissection technique is being used. The careful inspection by the surgeon and delicate placement of the hands suggest this.
The assisting nurse (probably, as mentioned, Sister Margaret Moir) stands to the patient's right side in the usual position, with what appears to be an instrument tray immediately in front of her. Curiously, this seems to have the reflection of her hand on its shiny surface, suggesting a stainless steel tray. There is no evidence of surgical instruments on it. A second nursing assistant looks on in the background.
It was Sir Alan Bowness who suggested that it would be appropriate for The Tonsillectomy painting in his possession to come to Melbourne, the home of the Foundation and the birthplace of Garnett Passe, the Foundation's nominal patron.
