Health does not simply impede the relationship between a maker and their medium. It restructures it. The work that emerges from a health-changed body in encounter with material often carries the marks of that restructuring directly in its formal properties. The constraint, the adaptation, the forced pivot: these are in the work.
Over decades of interviews with artists navigating health conditions, I have found that this tends to happen through a handful of recognizable patterns. The chronic pain that ended someone’s ability to stand at an easel. The medication that quieted the cross-contamination between parallel creative tracks. The fatigue that changed what duration of work was possible. The neurological change that altered how the brain constructed an image. All of these produced different work than would have existed otherwise.
This episode is the theory episode in the current series on creative medium. I work through seven mechanisms for how health changes medium, alongside the disability studies concept of misfitting from scholar Rosemary Garland Thompson, and seven artists whose work illustrates these patterns.
I really hope that you’ll join and support this work:
In This Episode:
The underlying concept: misfitting
Rosemarie Garland-Thompson introduced the concept of misfitting in a 2011 essay. Her argument: when a body encounters a world, material, system, or set of expectations that was designed for a different body or mind, the result is a misfit. The misfit is located in the relationship, not in the body. Stairs and a wheelchair are a misfit. Nothing is wrong with the person in the wheelchair. The stairs may be well-built. They simply do not fit together.
Applied to creative medium: when health changes a body’s relationship with a medium that was designed for or previously worked for that body, a misfitting occurs. What artists do with that misfitting varies. Some leave the medium entirely. Some renegotiate. Some invent an entirely new method. Some discover that the misfitting itself produces formal properties the fit could never have reached.
Nobody wants health issues, but many of us have them; adaptations sometimes produce work that would not have existed otherwise.
Seven mechanisms: how health impacts creative medium
1. The affordance shift
An affordance is the action possibilities that an object offers an actor based on that actor’s capacities. When health changes what the body can do, the affordances of a familiar medium shift even though the medium itself has not changed.
Faith Ringgold was born in 1930 in Harlem and trained as a painter working in oil on canvas. She was also a mother, teacher, and activist in New York City, living in small apartments, moving through the subway with children and materials. How do you paint large-scale oil canvases in a small, crowded apartment? With difficulty. In 1980 she created Echoes of Harlem, her first story quilt, made with her mother Willie Posey, a fashion designer. The shift to quilting was not purely aesthetic. Quilting material could be rolled up and put away. It could be carried on the subway. A wet oil canvas cannot be rolled up. Her circumstances made fabric the medium that was actually possible. The Tar Beach series and the story quilts that followed became the work she is best known for, formally innovative in ways that have influenced generations of artists.
Henri de Toulouse-Lautrec was born in 1864 and broke both femurs in falls at ages thirteen and fourteen, likely due to a genetic condition affecting bone development. His legs did not grow normally after those injuries. As an adult he was approximately 4’11” and moved through the cabarets, cafes, and music halls of Paris at a height that had no equivalent among the other artists in those rooms. He went up to the tables, close to the performers, at an eye level no one else had. The intimacy, the unusual angle, the sense of being inside rather than observing from outside: these are formal properties of his work that come directly from the physical position his condition gave him. His health changed what the visual environment afforded him as a viewer and as a maker.
2. The compensatory method
This is what happens when an artist cannot do the thing the established method requires, and the process of finding an alternative invents a method that takes the work somewhere the original never could.
Henri Matisse was sixty-seven in 1941 when he was diagnosed with abdominal cancer and underwent two major surgeries. He spent much of the following period bedridden or in a wheelchair, too weak to stand at the easel. He had been painting for fifty years. That was not one thing he did among many things. That was the only thing he had done. What he discovered while he was convalescing was something he did not plan for. He began working with large sheets of pre-painted paper, cutting shapes with scissors and arranging them into collage compositions he called cutouts. He described his scissors as the tool that finally gave him what brushes had not: the ability to cut directly into color, to create form and color simultaneously rather than sequentially. He was not adapting to paint despite his incapacity. He was doing something entirely new because he had to. The cutouts he produced in the last decade of his life, from the Jazz series in 1947 through the large-scale late works, are considered by many to be his most radical. The flat planes of pure color, the simplified shapes cut with the directness of a line: these qualities were not available to him in painting. They required the method. The method required the condition.
3. The material as body map
This is what happens when health changes what the nervous system can tolerate or requires from materials. The body begins navigating toward materials that meet those requirements in ways that feel more like biological necessity than aesthetic choice.
Louise Bourgeois was born in Paris in 1911 and worked until her death in 2010 at ninety-eight. She had insomnia across most of her adult life, severe and chronic. She described the hours between two and five in the morning as the hours when she could not not work. The weight of what she carried was too dense to sleep through. She kept fabric and thread by her bed. She would wake, reach for them, and begin making. The fabric pieces she made during those nocturnal sessions are different in register from her large sculptures. The Cells series is powerful in its scale and enclosure. The fabric works are intimate at a level the sculptures are not. They carry the body’s relationship with cloth: the softness, the warmth, the slight resistance of stitching. She described sewing as the action her hands knew how to do in the dark. The soft, repetitive, tactile engagement of working with fabric was doing something in those hours that the sculpture work could not.
I relate to this through crochet: having a nervous system that drifted toward yarn not as an aesthetic preference but as a regulatory necessity.
4. The persistence of knowing
This is what happens when a primary medium becomes inaccessible due to health, but the knowledge accumulated in that medium transfers into new practice in ways that could not have been designed in advance.
Sargy Mann was a British realist painter who spent his career painting landscapes, portraits, and figures in a tradition requiring precise observation of light and spatial relationships. In the 1970s he had a detached retina and began losing sight in one eye. His other eye deteriorated over the following decades. By around 2005 he was completely blind. He continued to paint for the next ten years, producing hundreds of paintings that were exhibited and reviewed without qualification. His method was elaborate: his studio was arranged so that every paint tube was always in the same fixed position, his palette laid out in a memorized structure, a long stick helping him navigate between canvas and palette. He worked from the accumulated knowledge of decades of looking: how light behaves, how color sits in relation to color, how figures occupy space. His critics noted that the characteristic of his work most identified as his own vision as a painter was more pronounced in those final ten years, not less. The knowledge of a medium, the understanding of what it does and how it behaves, does not live in the eyes alone. It lives in the hands, the body, the spatial memory, the aesthetic judgment built across decades of making. When the primary sensory channel was gone, the rest of the knowledge remained.
5. Scale compression
When health limits the physical scale of work an artist can sustain, the compression of that scale changes the relationship with the material.
Paul Klee was diagnosed with scleroderma in 1935. The connective tissue disease caused the skin and underlying tissue to harden and tighten, affecting his hands and his ability to make the fine, precise marks that had characterized his work. He adapted. He shifted to larger, simpler forms. The intricate, architecturally detailed earlier work gave way to paintings of singular broad figures, angels, arrows, all reduced to essentials. The marks he could still make. He produced nearly five hundred works in the last year of his life. He did not stop. He negotiated.
6. Duration constraint
When health limits how long a maker can sustain engagement with a medium, the work that is conceived for shorter units of time develops formal properties those constraints produce.
David Hockney began working on an iPad around 2010 and has spoken about using it in early morning windows, in brief periods during the day, in intervals that oil painting would have consumed entirely in setup and takedown. He calls it a discovery. The iPad work has formal properties different from his large canvases: the luminosity of a backlit screen, the scale of a tablet surface, a different relationship with line and color. He made a large landscape series during COVID isolation. He chose a medium whose accessibility matched his body’s available windows.
7. Cognitive restructuring of the visual image
This is when disease changes how the brain constructs the image.
William Utermohlen was an American realist painter who began a series of self-portraits in 1995, the year he was diagnosed with Alzheimer’s. He continued making them until approximately 2000, when sustained painting was no longer possible. The five major self-portraits from 1967 through 2000 are one of the most documented instances in art history of a neurological disease tracking itself through a medium. Looking at them in sequence, you see the spatial coherence change as the disease progresses. The 1967 portrait is organized and clear. By 1999, the face barely holds its position in the field. By 2000, a grey field, a faint suggestion of marks, perhaps an eye. His brain was losing the ability to form spatial relationships in the way it previously could. He could still paint. He could just no longer paint portraits in that previous way, because his brain was no longer seeing in that previous way. He participated in his own documentation. The work is a record of the disease and also a record of a maker who continued.
What this means for your practice
The new configuration between body and material produces things the original configuration could not. This is not a lesser version of the work. It is a different version. It carries the constraint in its formal properties. Understanding which mechanism is operating in your own practice is one of the things Creative Health Cartography mapping is designed to help you see.
Get the workbook:
