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Chemotherapy-day drawings

Hooked up and seated in the chemotherapy chair while undergoing treatment for bowel cancer for hours every fortnight, artist Clare Smith created about 70 abstract drawings. She started the drawings out of boredom, as a way to fill blocks of dead time. Although the bowel cancer is now in remission, during treatment it became clear that she also had late-stage breast cancer, for which she is still being treated. Her art is a testament to the power of creativity to bring respite in a crisis.

Words and artwork by Clare Smithaverage reading time 8 minutes

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Photograph of an abstract drawing on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. Many of the triangles within the grid are filled in with turquoise, light blue, light green and yellow ink. There is a an abstract mass of black ink in the middle, which shows the traces of the artist's brushstrokes. Above the grid are some small pink Chinese characters.
Chemo Day Drawings Series 1, February 2019. © Clare Smith for Wellcome Collection.

Like many people, I found the symptoms frightening and hoped they weren’t what I thought they were, but they were. In 2018 I was diagnosed with rectal cancer that had already spread. The surgeon suspected a connection with my breast cancer in 2010 but then said there was no connection. Turns out he was both right and wrong.

The period between the diagnosis, seeing the oncologist, and starting treatment felt very long and was beset by delay. When I did see the oncologist, I remember her saying she wanted to order some extra tests and “if there is a delay, it’ll be my fault”.

Of course, there was a delay: either the results weren’t in or she hadn’t seen them. My husband Roger and I both felt angry and frustrated, especially as the appointment for starting treatment was cancelled while we were having dinner the night before; a few days probably makes no difference, but at the time it always feels like it will.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is an abstract collection of disconnected shapes of different sizes, including several red circles with a black dot in the center and faint thin grey lines extending from them, grey-black fingerprint-shaped splodges with small hollow black circles surrounding them, and white splodges in different shapes. Thick yellow ink is placed at different points within the abstract mass of shapes. There are small lines lime green dots and tiny white dots with a navy outline. On the right are a collection of faded, grey and black splodges with a sharp bright red and white ink outline connecting the isolated splodges into an abstract structure. Surrounding the larger grey splodges' red and white outline are smaller circles either filled in grey or left hollow. Much of the red grid of the paper has been drawn over with think white lines.
Chemo Day Drawings Series 1, June - July 2019. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 1, June and July 2019.

What else does an artist do?

I started the drawings out of boredom. I had been playing Scrabble against the iPad and kept winning! So I decided there had to be a better way, as an artist, of spending the time. I started quite tentatively, sometimes doing one drawing, sometimes two. The drawings can at times be quite dense, and at others more open. Occasionally they feel more cellular. As time went on, they became more and more intricate.

The paper is cheap, throwaway paper for practising Chinese calligraphy, for writing. Gridded paper, a nod to modernism and the ubiquitous grid. But the ‘squares’ aren’t quite square. The lines not quite straight. The paper is thin and fragile, but strong at the same time.

There are marks already on the paper. Marks that have bled through from other drawings, in ink, or from coloured marker pens or watercolour paint. The paper tears or I make a hole in it, but it holds together.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is an abstract mass of different colour circles, round splodges and lines ranging in size and thickness. A long line of yellow and orange circles with a blue outline runs through the center of the page. Orange lines with a dotted blue and white border extend roughly perpendicular to the principal line of circles. The round splodges are dark, ranging from a light grey to a darker black. Some are surrounded by tiny blue dots, and others with small extending antenna-like pink arms. The dark splodges look cell-like in nature. On the right are a collection of navy blue abstract shapes, many congregating in a dense mass at the bottom of the page, whilst the other shapes almost seem to float above it. There are thick bright orange lines extending from the bottom of the page all the way to the top, which almost seem to connect the abstract blue shapes together.
Chemo Day Drawings Series 1, November 2019. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 1, November 2019.

The paper is a place

I travelled a lot as a child, never quite knowing where home was – it certainly wasn’t a place. The paper is a place. Lines appear, areas get filled in. I travel across, change direction. The drawings have been compared to maps.

My life has been shortened, but when I draw, time slows down. These are durational drawings on small pieces of paper that generally took four to six hours to complete.

Not all my work takes this kind of time, but these drawings are as much about time spent as they are about a moment in time, in my life. They are a record of presence, of still being here.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is a large abstract collection of very densely packed small circles, the majority of which are a bright blue, whilst some are grey and hollow and others are a red-pink. There is a broken pink line running from the bottom and extending round the page, encircling lots of the dots into a semi-structure. A broken yellow line is doing the same. A number of dark splodges, ranging from grey to black punctuate the smaller dots. Some of the dark splodges are speckled with white dots. On the right is a central blue structure filled in with a collection of tiny red and pink dots and lines. Larger green lines run through the structure as well, and extend outwards from it towards the top of the page, almost like a seed that is germinating. A few small black, brushstroke shaped splodges surround the central blue structure.
Chemo Day Drawings Series 1, November 2019 - January 2020.

Chemo Day Drawings Series 1, November 2019 and January 2020.

Two cancers

Cancer sounds like it’s one disease. It isn’t. Each cancer has its own cocktail of drugs and limited set of options. The side effects can differ too. I have fortunately not felt too sick, but I do get fatigue – an overwhelming tiredness.

Some treatment sent me to sleep throughout, in the chair itself. The rectal cancer treatment didn’t, so for the drawings I balanced a board on my outstretched legs and had my marker pens within reach on a little side table. It is important that these drawings were done in the chair as a response to site and context.

Something of their abstract, visceral qualities has fed into my other work. It’s as if the visceral signals (from the organs) were transmitted through the body and brain to my hand and into the drawings. The drawings are not about the body but are very much a response to being a body – drawing is a physical, mental and emotional act.

When I said the bowel surgeon was right and wrong about the rectal cancer, it is because no one immediately picked up the fact that my liver tumours were due to secondary breast cancer. One tumour is proving very resistant to treatment, or is “clever”, as my current oncologist says, so my options are running out as I write.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is an abstract collection of different coloured lines which seem to be expanding out from the bottom of the page in a number of different directions. Some are a thick, dotted navy or green line, whilst there are also thinner, feathery lines in different shades of red and green. On the right there are four spiralling structures extending from the bottom to the top of the page in two different shades of orange-red. The spiral structures look like pieces of DNA. There are small circles dotted along the spirals, some from which there are navy blue antennae-like lines splayed. The background is painted a solid light blue colour with slightly darker blue lines in stripes over it.
Chemo Day Drawings Series 2, August 2020. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, August 2020.

The chemotherapy treatment chair

The treatment rhythm depends on the chemo you get, but there is always pre-chemo two days before, which involves a blood test and checking on side effects. The treatment chair is a chunky blue recliner. Usually there is a pillow on one arm of the chair to rest your arm on while having the various flushes and intravenous treatments.

This is all set up by the nurses, who are absolutely wonderful: compassionate, caring and generally only up for conversation if you are.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is a connecting of dark splodges ranging from a dark black to a more faded grey. Some of the splodges are long, narrow and oval shaped whilst others are more rounded. Thin black pen lines, some solid and some dotted, are connecting all the splodges to one another, to form one single, cell like structure, with antennae like black lines extending from it. In the top left hand corner is a separate structure, a collection of small stripey shapes, some of which are filled with dark grey ink. On the right is a similar drawing to that on the left, with the same general structure visible, although is it more unfinished, with many of the black splodges not present, and instead replaced by miniscule black dots or softer white splodges.
Chemo Day Drawings Series 2, September 2020. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, September 2020.

Treatment during Covid

When Covid first hit, no one knew quite what to do. The then consultant, clearly working to a script, very mechanically told me I had to have a six-week treatment break before going on to new drugs. I was lucky in that I was still able to have treatment when so many cancer patients across the country were having to go without.

Before Covid, Roger would sit on a small chair next to me while the dog was at daycare. Now patients have to attend on their own unless they need a carer with them, although an exception is made for consultant’s appointments. So Roger waits for me, with the dog, outdoors, often fitting in a walk in the nearby woods.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left there are a number of cell-like structures with green and pink dotted outlines. Some of these structures are hollow, whilst some are filled in with faded black ink of varying shades of darkness. The pink structures are surrounded by small blue dots or tiny spikes extended from the structure's outline. Between the structures are chains of small red-pink hollow circles which run along the page vertically and are connected by small lines of the same colour.  There are several hollow cell-like structures at the top and left in the same colour as the red-pink small circles, with a green outline. On the right is a dense mass of abstract, unstructured shapes, the majority of which are either a vibrant pink-orange or dark navy with pink-orange stripes. Several of the smaller shapes are filled in with black ink. The shapes' outline is a solid bright green, whilst a more broken, dotted green ink surrounds them.
Chemo Day Drawings Series 2, October 2020. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, October 2020.

Visits to A&E

A & E is somewhere you do not want to go to while receiving cancer treatment, but a high temperature means you will be sent there. I’m sure the uncomfortable chairs are meant to keep you away unless you really have to be there. Once I ended up in A & E after the GP, over the phone, diagnosed an allergy causing my reddening middle finger and hand. The 111 on-call doctor suspected cellulitis.

In fact, it was a massive rheumatoid arthritis (RA) flare. I felt stupid not to have recognised it after all these years. I’ve had RA since I was 19. I sat on the hard chairs, some of them broken, until the nurses found a three-quarter-length sofa for me and one other patient, which was difficult to sleep on, especially as I find it impossible to curl up.

The regular trips to hospital, the exhausting effects of the treatment, the A&E ‘scares’ take their toll. Sometimes I just want to curl up and sleep and I can’t always find the emotional bandwidth I used to be able to find for supporting others.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is an abstract mass of densely packed hollow circles, the majority with a blue outline but a number with a yellow or green outline. Contained within the mass of circles, and connecting the circles into a single mass, are a number of dark, black ink splodes filled with white dots. Lots of thin, crimson lines are extending from the central shape, and leading to smaller abstract masses comprised of grey-black inky splodges surrounded by small crimson circles. The crimson lines extend from these shapes and off the page. On the right is a large arched shape extending through the page from top to bottom comprised of tiny etching marks or brushstrokes in black, blue and pink. Surrounding the central shape are a number of grey, cell like splodges which a number of pink lines bordering it, with these pink lines surrounded by small crimson dots. There are tiny blue lines dotted with navy or black ink connecting the central shape with the grey cell like splodges.
Chemo Day Drawings Series 2, November 2020. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, November 2020.

Suspected sepsis

The most recent A&E event was again due to a high temperature. On the day of my pre-chemo blood tests, I went back to bed after breakfast, feeling unwell, and rang the cancer day unit to postpone my appointment until the afternoon. I got very hot in bed and thought it was because I had too many clothes on.

I measured my temperature and it was nearly 39 degrees, but came down a bit. I got to the unit and my temperature seemed OK until I was about to leave, when I said I felt cold. Turned out my temperature was over 38 degrees again, so I was sent to A & E. I was diagnosed with suspected sepsis and put on IV paracetamol and at least four drips.

I had become a body in distress. It’s strange to be so in the body or to just be the body, that all you are is a kind of moan, rocking yourself for comfort, and longing for a bed.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. On the left is an abstract mass of tiny green, pink and dark blue brushstrokes. These strokes are broken up by a number of green and blue lines which extend out from the bottom right of the page. There are some dark splodges ranging from grey to black, whilst surrounding the green and blue lines and forming the background is a collection of densely packed, hollow yellow circles. On the right we can see an abstract, cell like shape comprised of pink ink punctuated with both blue and black splodges with a faint thin white outline. The border is made up of small, yellow circular shapes with a thin red outline. These yellow shapes are packed closely together, and extend outwards from the central mass, giving it some small branches.
Chemo Day Drawings Series 2, December 2020 - January 2021. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, December 2020 and January 2021.

From scan to scan

Over time I have become used to the rhythm of the 12-weekly scans. After each scan I feel apprehensive and sometimes dare to be hopeful, though my luck is running out now. Sometimes the scan reports have been encouraging, but there have also been the “not the result we were hoping for” moments, followed by new treatment and lots of finger-crossing.

I am on my last chemo options now. It isn’t that I am scared of dying. I think when the time comes, the process will be managed such that I get sleepier and sleepier and then slip away. I hope so, at least.

I do, though, feel sad and disappointed that I have to scale back my hopes for sharing and showing my work. I have missed opportunities to show it physically and have missed going to exhibition openings and opportunities to see other artists’ work in the non-Zoom world.

Photographic diptych of two abstract drawings on pink gridded Chinese calligraphy paper that is slightly crumpled and folded. To the left is an abstract mass of colourful splodges and very densely packed dots of different sizes and colours. The mass is surrounded by a broken red line, with a number of straight dotted lines in red and yellow extending out from it at different points. There are a number of black splodges with white dots inside them. Surrounding the red outline is a broken border of white ink, with lines extending from it out to the edge of the page. On the right is a collection of tiny circles, the majority of which are red-pink whilst some are dark navy blue. The circles range in size, and some of the larger circles are filled in yellow, whilst the smaller ones are just lines of alternating colour dots. A number of dark grey, fingerprint shaped splodges appear over the mass of dots, most of them slightly faded.
Chemo Day Drawings Series 2, January - February 2021. © Clare Smith for Wellcome Collection.

Chemo Day Drawings Series 2, January and February 2021.

Keeping going

After the diagnosis, Roger and I made sure we had done our wills. I gave away some things that I’d have given away later anyway, like some pieces of jewellery and books. Being pragmatic is a way of getting my head around things and I suppose there is a sense of being “in control”.

I keep going thanks to Roger, my friends and my family. And by continuing to draw. I do wonder whether the world needs more work by me. But then, I suppose, I make the work because that’s what artists do.

About the artist

Clare Smith

(she/her)

Clare Smith was born in Penang, Malaysia. She works from a studio in Dover. She has an BA from the University for the Creative Arts (UCA) and MA from the University of the Arts London (UAL, Central Saint Martins). She is co-founder of Dover Arts Development (DAD), together with Joanna Jones. Clare Smith was first diagnosed with breast cancer in 2010 and then unlucky to be diagnosed with bowel cancer in 2018 and then secondary breast cancer in 2019. As an artist, making drawings while undergoing treatment has been an important part of coping with being ill.