Regina Saphier: Advising Cancer Patients (the European Perspective of a Patient Advocate and Adviser)Posted: August 14, 2017
Regina Saphier: Advising Cancer Patients (the European Perspective of a Patient Advocate and Adviser)
Yes, I know, when you look at my LinkedIn profile, there are so many things on it, and yet you would not think that this is also something that I do. But I do it. I have done it for over a decade, and not because it is fun to read about cancer, but because I like to help people stay alive and I am able to ask good questions and am OK with reading complicated research papers (sometimes the summary, the intro or the conclusion are perfectly enough, but other times I have to read for hours to really understand a method and/or procedures). I like to explain things as well, and I prefer to write because a written explanation is always there for people to consult. Disclaimer: I am not a medical doctor, I am not a clinical researcher, I am not a diagnostician, and I can’t cure you of any illness. I am just a human being who does not see a key service that people need… so, I do it for them… a guide who helps desperate people understand what their doctors are saying and find out what doctors are not saying. I help people fight for their lives more efficiently when I am able to.
Infantilization of patients in the era of readily available high level online knowledge
The really good ones were all female!
First, let me talk about the good doctors I encountered. Fortunately, I encountered a few bright, open minded, emotionally intelligent, introspective and cooperative doctors. I even had a female doctor congratulate me when I told her how I diagnosed an illness that was unusual and it was later confirmed by lab results (I had to behave like a detective, pick people’s brains, read online, and I had to push for tests… it was’t easy). I also had a doctor in Europe who asked me for full articles that I downloaded from Harvard University’s server. I had a particularly brilliant doctor at Columbia University. She was fun, smart, and was always willing to explain everything to me. I had a doctor (also in Europe) who was even happy to explain the technology she used. She told me that I was the first patient ever who asked her to do that. All of them were female doctors! The really good ones were all female. (It is interesting, because I have no female friends. All of my friends are male and highly intelligent. So, it is surprising that when it comes to doctors, I prefer women. Note: I once read that female doctors are simply better. It is probably because of better social skills and listening skills. I am not saying that male doctors can not be good. All I am saying is that I have never seen them. Sitting in your office and administering medication and ordering lab tests is not what I consider the job of a good doctor. It is so much more complicated.)
There were doctors who were professionally famous but as human beings those were often the worst (I would naturally be kinder to a horse or a dog than those people were to me… those were mostly male doctors). In the age of medical AI it is your humanity that will be important, not your medical data driven memory… even your medical experience driven diagnostic skills will be less of a priority after a while. If you want to remain a doctor and become a really wonderful one, develop your emotional and social skills, focus on your communication skills, be comfortable with technology (like AI), plus learn to embrace and utilize the fact that more and more people are acquiring knowledge online. If you dislike their sources, direct them to the right sources. Be their guide in the medical jungle that you know better. Listen to their personal patient narrative, that they know better.
I posted this in 2016 as a status update on facebook:
Here is what I think:
This is the age of The Idiocracy in the age of unlimited and available knowledge…
And the age of The Out of Touch Intellectual and Political Elite in the age of unlimited connectivity…
My opinion hasn’t changed a bit!
How it “works” now
Most people just accept what their doctors are telling them. I am not that kind of person and most doctors hate that. I am looking forward to the day when I am going to have my own medical AI to prevent, treat or even cure illness (without having to see a human doctor). Unfortunately, most doctors today adopt a mindset that is based on viewing patients as “the other” (this is an international phenomenon and it is not new… in fact this horrible attitude is hundreds of years old). So, to me the expression: “patient” describes a submissive, child like “know nothing”. This to me is military grade bullshit. An archaic hierarchy based mindset created the idea of the “patient”. The doctor is “the know it all” character of this type of medical story. So wrong! And it is not even true! Most medical doctors are not scientists and are often terribly misinformed, yet super arrogant!
I would like to live in an era when all people are well educated and highly able to interact with medical technology. I just witnessed how a cancer patient had to wait months to get properly diagnosed and she is still not getting her treatment. Why? Because her oncologist is not willing to cooperate (not open to questions) and now even went on holiday, and because the patient behaves like a child… let me be more specific: she is forced to behave like a child by her passive-aggressive medical practitioner (plus, she is hardly able to understand the most basic explanations, because she was never educated in this area… and she did not educate herself in this area… so, a lot of time goes by without actual diagnostic and treatment related progress).
How it should work (in my opinion)
If the process would be automated I could have helped her faster without human doctors. Press two if you already had cancer… Here is how it should work in my not so humble opinion:
Press three if you are inoperable… Press this or that if you are not willing to receive chemo… Please, proceed to this and this specialist for a surgery free biopsy… Please, watch this video to understand the risks associated with biopsies… Please, go to this menu if you would like to speak to someone regarding your personal risk based on your medical history… Please, make an appointment in this menu for an MRI and a PET/CT. Please, request a lab test, including genetic testing. And a few days later: This is the type of cancer you have. These are the types of treatment combinations you can receive in your country, within the EU, in the US, in Asia, or anywhere in the world. These are the commercially available options. These are the clinical studies you could be eligible for. Here is where you can start registering for treatments. Here you can read full medical articles on PubMed. Here you can find patient readable summaries of the articles on the medical wikipedia. This is how much the different treatments cost. This is the most cost effective treatment for you. Here is your big data and AI based outcome analysis for all the treatment combinations. This is where you can receive financial support. This is the surface where you can raise funds online for your treatment. Thank you for selecting this noninvasive surgery in Italy and this cancer vaccine in Germany. Please, watch this video regarding the risks involved and here is the explanation how this is a safer method compared to another. Here are the clinic’s safety statistics locally, regionally and globally. Please, select the doctor you would like to see at our clinic. Here is your doctor’s performance rating. Here you can order your EU insurance card. Here you can contact your doctor via skype. Here you can book a medical flight and a medical stay in a nearby hotel or in our own hospital based hotel room. Here you can interact with patients like you.
Yes, I want this all to be online, and globally integrated. I want this to be a smooth service, like any other good service. I want as much stress be removed from the process as possible.
More about how it works now:
Doctors often behave like badly trained policemen. It is a bit like racism! I am telling you, it sometimes feels like I am talking to a white supremacists male police man while being a black female driver on a deserted country road, or something like that. I am white, but I can imagine the generalized anxiety and trauma such people cause innocent and vulnerable citizens. This best describes the atmosphere many doctors create while “serving” you. It often feels painful when I am interacting with a doctor. It is physically painful and it gets my sympathetic nervous system going… and that is directly damaging to a patient’s health, medical outcome and trust. So, doctors with this mindset should know that their behavior directly generates distance, stress, pain and a hostile environment that often results in more illness, instead of a cure in the first place. Many years ago I read the confessions of a doctor who only realized how she was hurting her own patients when she herself ended up being a patient. She could not believe the dehumanizing, insensitive, disrespectful and ignorant behaviors of her colleagues while she was a patient.
How can there be any trust when your doctor is not respecting you, does not see you, does not appreciate you as a complex and evolved human being or is even afraid of you because you are well read and are asking valid questions? Of course trust cannot be built this way! These people treat me as if I am reading homeopathy related articles (I think homeopathy is bullshit), when really, I am reading PubMed and similar advanced medical sites, that are there for medical doctors, smart nurses, diligent patient advisers and intelligent patients to educate themselves. And yet, I am treated like an idiot, with all the prejudice a human doctor can accumulate about a patient with higher education, fluent English, international experience, and the ability to understand the scientific literature that doctors are also supposed to read (but often don’t even have access to those databases or don’t have the language skills to understand the articles… it is everyday reality in Hungary for example, that doctors have no access to the latest medical literature and/or can’t read in English… many hospitals don’t have enough nurses, doctors, medications, appropriate technology and no toilet paper and no soap… even the furniture is falling apart… the rooms were not painted for decades… imagine that… and Hungary is part of the EU…).
Yes, indeed, I feel the abyss between the everyday realities of our dystopian present and my perfectly implementable utopian future.
Excuse My French!
So, in my experience, doctors switch to cognitive empathy instead of affective empathy and some even enter the realm of transient psychopathy coupled with professional denial. This behavior is next rationalized (by medical professionals as a group) as normal behavior, and vulnerable patients are often (excuse my French) fucked by this atmosphere, because even the nurses help maintain this by saying things like: “Yes, we know that he is insensitive and has no people skills, but this is why we are here… to compensate for his lack of sensitivity and empathy…” and she goes on being insensitive herself… In this insensitivity bubble (surrounded by desensitized medical professionals) patients suffer in silence. (Patients sometimes even display symptoms of a sort of “medical Stockholm syndrome”… identifying with those people who basically torture them in a horrible medical system, saying things like: “I know how difficult it is to work in such an underpaid, stressful environment”… when really, all you see, is that a particular doctor was never trained to be polite, kind, able to listen and empathize…) All the traumas patients accumulate during years of medical (mis)treatments can and will result in PTSD (post traumatic stress disorder). Generalized anxiety and stress related disorders undermine a patient’s chances of survival. When (due to past experiences) someone’s cortisol level jumps high just by thinking about having to go to a hospital, that will decrease that person’s life expectancy. And if you look for the most lethal conditions in humans, cortisol imbalance and chronically high cortisol levels are one of the most lethal conditions.
I am describing the atmosphere that leads to mistreatment, cruelty and humiliation. I used to trust doctors when I was younger and naive. But when I got seriously ill in my thirties and I encountered the above attitudes and doctors’ inability to help me and unwillingness to cooperate with me (there was even this obvious disapproval… and get this: even scolding for my informed questions), I discovered that most doctors simply cannot be trusted and often, you are on your own when you are ill. Literally, on your own, because your family (most likely) has no idea how to read scientific literature and don’t have your curiosity, stubbornness and grit to learn about medicine (if you have those features, you might not be 100% lucky in your ignorant human network… smart kids are bullied in schools and smart patients are bullied by doctors).
Patients also like to treat doctors as the “other”. “The doctor knows.” “The patient does not know.” This is a nineteenth century or even older attitude and “agreement”. Totally outdated! This is why I started to read the medical literature that doctors are supposed to be reading, as well as many patient blogs that knowledgeable patients write about their experiences. Unfortunately, I have not yet found the enlightened doctors to work with in my own personal environment. At the same time I reject unenlightened doctors. I have seen how “health care” and “healing” resulted in completely ruined bodies and souls. When a patient looks and feels like he or she was tortured by someone at the end of a treatment, plus his or her family was ruined by the experience… is that medicine or barbarism? This situation of rightfully rejecting medical barbarism could even kill a patient, no matter how informed he or she is, because such patients are disgusted by doctors who dehumanize and disrespect them. I am not a patient! Rather “impatient”! If I have to respect you as a doctor for your knowledge and time, should you not respect me, my knowledge, my time and my life? Look at me! I am a human being just like you!
What is special about my position as a patient adviser and advocate is this: Most oncologists are specialists. They are following a protocol and only read about their specialty locally (if they read at all…). But when you are a volunteer patient advocate and adviser (plus sometimes a patient yourself) with a global mindset, you read about many different illnesses and all sorts of treatments, even experimental ones, and even about treatments that are not yet mainstream and cost an exorbitant amount of money. “Multipotentialites” (everyday “polymaths”), like me, we read about everything under the Sun. Most doctors hate that and we will be bullied by doctors. This is absolutely wrong!
A bit about volunteer patient advocates and advisers
Patient advisers and advocates are often volunteer “medical sherpas”. They don’t really want to go where you go, they don’t have your problem, but out of love and with lots of empathy they pick up parts of your problem and carry parts of the burden for you, so you don’t have to. Such people will explore new paths of hope for you while you are asleep. Will explain medical procedures when you don’t understand, and remind you of the right questions you should ask your doctors. We do the heavy intellectual lifting to lighten the load of the struggle for patients and for doctors as well. We listen, do research, we network and search for answers, and explain. We translate the jargon. If you like, we repeat things ten times until you understand. We encourage you to be assertive. We tell you to expect more. We also tell you about the limitations and we don’t pretend that life is endless. We hear you and acknowledge your limitations. We know that every patient has a different endgame as well. Some want to try every possible treatment, no matter where it is. Some don’t want to be treated abroad. Some want to have a few good last years. We want you to make an informed decision for yourself. We never force you to do anything. It is your life.
A new type of medical training
It would be interesting to train doctors in a new way… Have them train like debate teams. When learning to debate, people learn to argue in support and against something. The same way, doctors should be trained to argue their positions from both a medically trained doctor’s perspective and from a well read patient’s perspective, and even from a completely uneducated patient’s perspective. This would help even those doctors with impaired empathy to improve their communication skills and would gain insight into patients’ anxieties. Even if you are a surgeon with psychopathic traits and zero affective empathy, you can learn to believably pretend to empathize and so put your patient at ease. An anxious patient with high blood pressure in surgery is at risk. If you can get your patient to trust you and relax, the surgery will be safer.
Artificial Medical Intelligence and the future of self-guided health care
I am one of those who believe that AI will be our highly personalized health care provider. Those adults who are well educated will be most able to access superior medical services to prevent illnesses by using medical AI first (and the eight year old girl who grows up while interacting with AI fluently… You know the scenario when a kid is constantly scolded: “Why are you always playing with your AI…?” and then one day: “Oh, did you just save your grandmother’s life with your AI???” But, of course, I am not talking about basic Artificial Narrow Intelligence. I am talking about either medically specialized Narrow Intelligence or later Artificial General Intelligence used in medicine and much later Artificial Superintelligence… it will feel like god to many people…)
Prevention will be the primary goal. Medical AI will be the first line of support and most human medical appointments will be done online. Most surgeries will become noninvasive. In fact the day will come when people will not believe invasive surgery by humans was a thing. I even suspect that hospitals will one day be completely obsolete. So, one day, hopefully, my medical learning capacity, my openness to technology and my AI interactive skills will be helpful when trying to figure out a treatment for myself and others and I would not have to go to a doctor’s office at all. I could just consult with several pre-selected doctors globally. Send me the medicine in the mail or let me print it. There should be more medical education in high schools (and online) and all people should learn how to make sense of clinical research papers (until this part can be completely taken over by medical AIs). People should not be so dependent on doctors and their very limited skills, questionable humanity and finite time. Your health is too precious to search for the right doctors for years! You should not have to go bankrupt during a treatment. Your family members should not get sick of the stress your prolonged care causes. Adults shouldn’t have to behave like helpless little kids while being treated within a questionable healthcare system.
Advocacy and advising people in practice (a mini case study)
I advise people voluntarily for free (and I avoid confrontation with doctors left over from the nineteenth century… not even the twentieth!). I do not advertise this activity. I help people with information. I support their decisions by summarizing the discovered possibilities beyond the local medical protocol. For example when a family friend had cancer I decided to search for a clinical trial for him (he did not want to be treated abroad) and when I found the right one, I gave his wife a phone number to call and explained the process. He had metastatic lung cancer 10 years ago (with bone metastasis). Luckily, he was a genetic match for the study I suggested (after picking other people’s brains for days). He lived an additional 5-6 years because the new treatment worked for him (in Budapest!). Today, an additional 5 years of survival could mean a possible cure that is under investigation now… but perhaps becomes a fully available, genetically targeted cure in 4 years for example.
Combination therapies (based on genetic testing and imaging)
It is important to note that today, cancer treatment does not mean one standard for all. Treatments are combined for individual needs. You can have:
- Herceptin if your breast cancer is Her2+ (Human epidermal growth factor receptor 2 positive breast cancer patients are a minority among breast cancer patients, but have a very good and specialized treatment option… however, live with an aggressive type of cancer that is likely to return, precisely due to the growth factor receptor, that is also the target of the special treatment),
- Arimidex if your cancer is hormone sensitive,
- Proton radiation therapy if the cancer is in an area that does not move during treatment (proton radiation can be better targeted and causes less damage),
- MRI guided Ultrasound Surgery if you do not want a surgeon to cut you open, and a
- Cancer vaccine to help your own immune system fight the cancer.
You can have all of these combined. Cancer is tricky. Today we are still in the “kill” paradigm, but one day the “return the cancer cell to a normal cell” paradigm will most likely rule.
This list is actually a fresh one I compiled for a patient with recurrent breast cancer that metastasized into her adrenals 5-6 years after her first diagnosis and treatment. Her prognosis was really bad, but she is still alive after 5 years! For her type of breast cancer it is extremely unusual to have adrenal metastasis and due to her general condition, she is inoperable. Now, even the biopsy was tricky. In the treating hospital (the leading one in the country) her doctors were unable to even imagine the biopsy without invasive surgery. She had to go to another hospital to see a specialist for ultrasound guided biopsy (no invasive surgery was needed for the adrenal biopsy!!!). Her oncologist only suggested chemo (I informed the patient, that chemo might spread her cancer without surgery… also, a biopsy could spread cancer cells), Herceptin (in my opinion, it should have been started within a month after her metastasis was diagnose, yet months later she is still not being treated) and Arimidex (also helpful). Her oncologist did not say anything about commercially available proton radiation therapy, MRI guided ultrasound surgery and personalized cancer vaccines in the European Union. I told her about these.
When necessary, I also look for top surgeons internationally (e.g.: for colon cancer), and possible treatments for adrenal cancer, like the personalized cancer vaccine (for the patient with adrenal cancer). When I do this research, I regularly pick other people’s brains internationally and read many articles to help patients and their families. But I never tell people what to opt for. I only research, list the options and explain them (and their possible combinations). The decision making is the patient’s personal task.
I think there should exist independent advisory teams for each patient in highly demanding situations. If you have never been ill, if you never had a relative who was ill, if you are a doctor who never experienced illness as a patient or family member, you have no idea from a patient’s perspective and from a relative’s perspective how terribly demanding it is to be ill, find your way in the maze of medical institutions, understand lab results, question your doctor’s opinions and suggestions, read, learn, be a caretaker, take care of yourself, work, be a mother, a father, and look for better treatment options (often internationally). People are fighting for their lives in a dehumanizing and confusing system! And you are lucky if you have the funds to finance the shocking expenses.
Advising cancer patients is a side project I do because I am able to. So, why not? Right? I wanted to write a summary blog about several of the possible treatments that people usually don’t get information about from their run-of-the-mill oncologists (below I am going to add a long section about treatments and medical technologies). Getting the best information really should not be a matter of chance in the age of the internet, AI, big data, citizen science and epic, interactive, multiplayer online games! There is so much information out there that could be useful to many people. I even have a concept of a medical science game for this purpose, for citizen scientists and even professional scientists. Saving a real human’s life in an online game would be much more epic than killing an avatar in an online game! In fact I am already working on this game idea!
OK, now that I managed to vent, I am going to talk a bit about the cancer treatments I encountered or revisited during the last couple of months (and this is just a short list, because I read at least a dozen articles regarding cancer treatments by the time I get up every day):
Personalized cancer vaccines (Example #1)
Cologne, Germany, European Union
Immunologisch Onkologisches Zentrum Köln (IOZK)
VOL-DC (Viral Oncolysate Loaded Dendritic Cells) or NDV/DC Immunotherapy (Newcastle Disease Virus/Dendritic Cell Immunothrapy)
You should have seen the different ways in which I attempted to explain the brilliance behind this safe treatment. I went from the scientific summary to the theater method: I portrayed the beautiful dendritic cells as ballerinas in tutus going swimming in the tumor specific antigen swimming pool in the lab (made possible by viruses), and later showing off the antigens like glitter to the T cells in the body. In turn the T cells are hopefully able to kill the cancer cells, because the cancer cells can no longer hide. I can see this in my head as an animation. I seriously tested every possible explanation level to get the message to the patient who is a female close to 70.
I heard about this method on the radio and did a few days of research. First, it sounded too good to be true. You just waltz into an office in Cologne, get tested and if your immune system is in good shape and if you have tens of thousands of euro in your bank account, you can get this extremely safe cancer treatment that might extend your life by years… and in a few cases even clinically cure some people. If you are lucky, this way, your own immune system will be able to kill the cancer. No toxic materials are used.
The patient, because she is inoperable, decided to go see if this would work for her. During the travel preparations she had an accident. She fell and hurt herself badly (in front of a building where she had to go in person to get her EU insurance card!!!). She still got the airplane tickets and was in Cologne within a few days with her husband. She wants to live!
I really don’t understand why this clinic does not send healthy, fit, medically trained employees to travel to such patients internationally. I mean, people in their late sixties should not have to travel up and down internationally to find the right treatment! Again, making everything convenient for the doctors, and stressful and dangerous for the patients. The patient should rest and his or her stress level should be kept minimal, yet it is the patient who has to go everywhere and wait hours and days for some attention (while risking accidents and infections). And in this case we are talking about a private European clinic in Germany!
Anyway, the results showed that she could benefit from the treatment. However, the clinic made a huge mistake! They promised to send the results in two weeks via e-mail. Instead, for some absolutely unclear reason, there was promise after promise for 5 weeks! Imagine how a patient (who is basically terminally ill without the appropriate treatments) feels while this is happening. The trust is gone! You run to Cologne, spent thousands of euro on airplane tickets, hotel nights, blood tests, and you are made to wait over twice the promised time period and that without any explanation and without any apology from your doctor! I mean, this was clear service error. This is unacceptable! The least those people should do is refund the money. Who would want to be treated by a clinic that behaves in such irresponsible and disrespectful manner? All I can say: Shame on IOZK! If you were the ones able to save this patient, if you wanted to save this patient, how could you treat her like this? Don’t you understand that you are in the business of trust, communication and saving human lives? It is very possible that this patient will live a shorter life because she can no longer trust you and can’t accept your treatment. She now thinks you are selling a hoax and I can’t blame her (even though I know that your method is medically valid). I personally think that the lab results were valid, useful and the treatment could work. But I can no longer expect this patient to trust IOZK. Obviously! And why do I have to write angry letters to a private clinic in Germany to get the lab results that cost the patient 3000 euro 5 weeks earlier? As if we have unlimited energy… (What are these people thinking?)
I could see from the results that the patient’s adrenal cancer was HER2+, so Herceptin will be an option again. But because she could not trust the results sent by IOZK, she had a biopsy that was/is not without risks. The biopsy reinforced the blood test based results. But with all the enormous effort by her, by her husband and by me, how is it possible that it took so long to get her these results? She was diagnosed during the spring and it is now August and she still did not get any treatment. What kind of medical system is this??? What are her doctors doing??? And now, because it is the summer, her oncologist just went on holiday! Yes, now that she knows what treatment she needs, she still has to wait! This is abnormal and unethical!!!
Personalized cancer vaccines (Example #2)
Suddenly, another personalized cancer vaccine turned up on my radar in Düsseldorf, Germany. I did not yet explore this one further, but I put it here for people who are interested:
NEXTGEN ONCOLOGY GROUP
Univ.-Prof. Dr. med. Hans Bojar
This is from the website:
“The NextGen Oncology Group concerns itself with the further development of precision oncology treatment. Since tumors are as individual as a fingerprint, cancer treatment can only be successful if it takes this individuality into account. Using highly innovative procedures, we determine a patient’s molecular fingerprint. Pan-genomic gene activity analysis, next-generation mutation analysis, and many other procedures are the technologies necessary to personalize treatment.
The standard cytotoxic chemotherapy has long since been overtaken by the intelligent, personalized targeted therapies that are now at the heart of scientific inquiry.
Modern, molecular-genetic technologies are the basis that allow identifying individual treatment targets. The recent development in cancer vaccines has also raised high expectations and hopes. By analyzing the entire human genome, a tumor’s individual mutations can be determined. This then allows creating absolutely personal vaccinations which are as individual as a fingerprint. These new therapeutic options will significantly change the treatment of tumor diseases in the years to come.”
Another type of immunotherapy: Chimeric Antigen Receptor (CAR) T-Cell Therapy
In this case new receptors are added to patients’ own harvested and later re-injected T cells. Very promising method, but can be more dangerous than the personalized cancer vaccines.
From the wiki article:
“Chimeric antigen receptors (CARs), (also known as Chimeric immunoreceptors, Chimeric T cell receptors, Artificial T cell receptors) are engineered receptors, which graft an arbitrary specificity onto an immune effector cell (T cell). Typically, these receptors are used to graft the specificity of a monoclonal antibody onto a T cell, with transfer of their coding sequence facilitated by retroviral vectors. The receptors are called chimeric because they are composed of parts from different sources.
CARs are under investigation as a therapy for cancer, using a technique called adoptive cell transfer. T cells are removed from a patient and modified so that they express receptors specific to the patient’s particular cancer. The T cells, which can then recognize and kill the cancer cells, are reintroduced into the patient. Modification of T-cells sourced from donors other than the patient are also under investigation.”
News regarding metastasis prevention:
This is also interesting and relevant:
Johns Hopkins researchers say they’ve unlocked key to cancer metastasis and how to slow it
From the article:
“When the tumor reaches a certain density, the study found, it releases two proteins called Interleukin 6 and Interleukin 8, signaling to cancer cells that things had grown too crowded and it was time to break off and head into other parts of the body.”
“The team then tested two drugs known to work on the Interleukin receptors to see if they would block or slow metastasis in mice. They found that using the two drugs together would block the signals from the Interleukin proteins that told the cancer cells to break off and spread, slowing — though not completely stopping — metastasis.
“The drugs the team used were Tocilizumab, a rheumatoid arthritis treatment, and Reparixin, which is being evaluated for cancer treatment.
The drugs bind to the Interleukin receptors and block their signals, slowing metastasis.
Though metastasis was not completely stopped, Jayatilaka said, the mice given the drug cocktail fared well and survived through the experiment. She said adding another, yet-to-be-determined drug or tweaking the dose might stop metastasis entirely.”
Do the most extensive genetic testing possible!
Keep this in mind when your outdated oncologist tells you that no extensive genetic testing is necessary:
Clinical impact of extensive molecular profiling in advanced cancer patients
From the article:
“Extensive molecular profiling using high-throughput techniques allows for the identification of actionable mutations in the majority of cases and is associated with substantial clinical benefit in up to one in four patients.”
Highly targeted cancer treatments are here for very specific mutations!
A New Cancer Drug Helped Almost Everyone Who Took It
From the article:
“… the DNA of his tumor was sequenced, and he was entered into a clinical trial for an experimental drug called larotrectinib. He felt better within a day. Within 72 hours, he no longer needed a cane. Within two weeks, he was walking around Manhattan on his monthly clinical trial visits, playing with his kids and eating like a champ.
Laurie’s experience isn’t unique. Results in the first 50 patients treated with larotrectinib are being presented today at the annual meeting of the American Society of Clinical Oncology, the biggest gathering of cancer doctors.”
“Loxo Oncology was founded in 2013, the brainchild of an oncologist named Joshua Bilenker, who was then working as an investor at Aisling Capital, a private equity firm. Between 2004 and 2006, Bilenker had served as a reviewer in the oncology division of the Food and Drug Administration, working on applications for new uses of cancer drugs like Rituxan and Herceptin.”
FDA Clears First Cancer Drug Based on Genetics of Disease, Not Tumor Location
From the article:
“Merck & Co’s immunotherapy Keytruda [pembrolizumab] chalked up another approval on Tuesday as the U.S. Food and Drug Administration said the cancer medicine can be used to treat children and adults who carry a specific genetic feature regardless of where the disease originated.
It is the first time the agency has approved a cancer treatment based solely on a genetic biomarker.”
“The accelerated approval was for solid tumor cancers not eligible for surgery or that have spread in patients identified as having a biomarker called microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR).
Tumors with those traits are most common in colorectal, endometrial and gastrointestinal cancers, but may also appear in cancers of the breast, prostate, bladder and thyroid gland.”
There are many promising new, targeted treatments
Immune checkpoint inhibitors to treat cancer
List from the site:
“PD-1 inhibitors: Examples of drugs that target PD-1 include:
PD-L1 inhibitors: Examples of drugs that target PD-L1 include:
Journal for ImmunoTherapy of Cancer
Novel technologies and emerging biomarkers for personalized cancer immunotherapy
From the article:
“These therapies are revolutionizing therapeutic concepts and changing the standard of care for cancer treatment. Immunotherapy is now widely accepted as a key component of the therapeutic strategies to control and potentially cure cancer. Moreover, immunotherapy has the potential to cure or convert cancer from a fatal disease into a non-life threatening or chronic disease. The concept of a “clinical cure” is emerging as a description of long-term tumor control. The broad potential for a clinical cure is now being extensively explored by both mono and combination cancer immunotherapy.”
Modern, highly targeted radiation therapies
Heidelberg Ion-Beam Therapy Center (HIT)
Heidelberg University Hospital
From the site:
“Ion beam radiation, also referred to as particle radiation. Protons and heavy ions are positively charged atomic nuclei (particles). Protons are positively charged nuclei of hydrogen atoms. Heavy ions are positively charged nuclei of atoms with a greater mass (at HIT, carbon, oxygen and helium ions are used). Ion radiation guarantees the highest possible precision. In addition, heavy ions have greater clinical efficacy than conventional irradiation with the same dose of photons.”
RINECKER PROTON THERAPY CENTER (RPTC), Munich, Germany
From the site:
“With Proton Therapy higher dosages in the tumor are possible and at the same time there are significant less side effects.”
Let the video explain:
RINECKER PROTON THERAPY CENTER: Proton Therapy
This method is effective in tumor cells with somatostatin receptors. Lutetium-labelled peptides are used to kill the cancer cells. If you like to know more, here is an article:
Lutetium-labelled peptides for therapy of neuroendocrine tumours
From the article:
“Treatment with radiolabelled somatostatin analogues is a promising … tool in the management of patients with inoperable or metastasized … tumours.”
Noninvasive ultrasound surgery
Magnetic resonance imaging (MRI) guided high-intensity focused ultrasound (HIFU) surgery could beautifully complement cancer immunotherapy. Did you know that MRI HIFU was invented and developed by a Hungarian doctor? He lived and worked in the US. Unfortunately, he passed away recently. And did you know that Hungarian hospitals refused to purchase an MRI HIFU machine a few years ago? It is a wonderful tool! It is available all over the world! It is in the early stages of development as laparoscopy was over 10 years ago… It is very promising! Of course Hungarian idiot decision makers did not want one!
So, I discovered the brilliant entity called:
Focused Ultrasound Foundation (in the US)
And their website has the most comprehensive search tool if you would like to search for a HIFU treatment in a country by organ treated! Currently the database has 588 treatment sites globally!!!
It lists several Italian institutions offering commercial HIFU treatments for kidney tumors (no word regarding adrenal tumors…).
- Careggi General Hospital, Florence Italy
- Cisanello Hospital of University of Pisa, Pisa, Italy
- European Institute of Oncology, Milan, Italy
- Rome American Hospital, Rome, Italy
- Sora Cancer Centre, Sora, Lazio, Italy
Always consult specific websites and it is best to contact the institution directly via e-mail or phone!
EUROPEAN INSTITUTE OF ONCOLOGY, Milan, Italy
From the site
“IEO [Istituto Europeo di Oncologia] is the most advanced developing Center in using HIFU technology for cancer treatment in the West. HIFU is a cutting-edge, non-invasive technology, developed in China* for destroying cancer without scalpels, irradiation or needles. Interventional Radiology in IEO has the largest number of HIFU cancer treatments in western countries.”
*There are several different types of HIFU equipment globally.
Clinical trial and medical science resources:
From the site:
“ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world.”
From the site:
“PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.”
EUROPEAN SOCIETY FOR MEDICAL ONCOLOGY
The leading European professional organisation for medical oncology
Apps, Labs, Data, Image Analysis, In Silico Testing and Artificial Intelligence
Now about a research tool and service that could support treatment related decision making
The Oncompass app
On this site, patients and doctors can look up clinical trials ranked by relevance for specific cancers and doctors can also add their own experiences with treatments immediately! It is free! This is a Hungarian app of a molecular diagnostics company (Oncompass), but its users are global! I just discovered it recently (I tested it a bit, but I did not use it for treatment search). Could make the search for a treatment or even a cure so much easier! Plus, it empowers e-patients and helps doctors expedite info sharing regarding treatments globally!
Note: Today it is not (yet) the state delegated oncologist in Budapest, Hungary (where healthcare is not up to EU standards) who tells a patient that there is for example LOXO 101 in an open clinical trial (e.g.: in Denmark) and that Loxo Oncology takes patients for free (!) to international locations, for free (clinical trial related) treatment with one of the safest and most successful cancer drugs in development (it targets a select group with a rare genetic mutation… and for those with the mutation it is apparently amazingly effective and sometimes even curative even in very advanced cases). It only helps a very small group of people globally with a very specific mutation, but those people see amazing results and Loxo Oncology is looking for them! This isn’t something that a regular oncologist shares with you and you do not even know how many facts are not being shared with you that could potentially save or prolong your life! It is the multidisciplinary long-form blogger and digital artist (me, Regina Saphier) who will dig this up online (and not with the free Oncompass system that I just discovered recently… perhaps one day I am going to use that one too, but it is very difficult to register a patient in it without the cooperation of the oncologist, the patient and other doctors).
I immediately noticed that the Precision Medicine Calculator (by Oncompass) has no registration and login option for friends, family, patient advocates/advisers and other caretakers. Yet, in many cases, in such stressful situations, it is this support network that helps patients find answers. And I can’t believe how many internet domains Oncompass has… at least 4… it is really confusing. But I appreciate the idea of this free and global app. It “just” has to work well now, and for that people need to know about it and people have to use it (and it regularly needs to be improved).
Oncompass Medicine is one of the companies in Hungary that does oncogenetic testing (another superior genetic sequencing service is provided by PentaCore Lab). At Oncompass
58* 600 genes are tested when searching for a cancer treatment, and there are specialized support options beyond the lab work and that is very important. (*Update on October 19. 2017: Oncompass recently started to analyse 600 genes and the full exome of patients!!! Ask for the Oncompass All Dynamic Program!!!). At PentaCore Lab, 400 oncogenes are sequenced (Vivaton 400). Duna Medical only tests 65+27 genes. In the US there are tests with hundreds of genes (similar to the Oncompass All Dynamic Program and the PentaCore’s Vivaton 400 panel in Budapest). When personalized cancer vaccines are developed for a patient, the best thing is to have the entire genome sequenced (by entire I mean even the healthy genome). That helps you find the best treatment targets.
There is so much information all over the place, that both patient networks and doctors need a reliable decision support system. If I could make decisions about this, I would even make medical AI based Enlitic available to patients and their networks as well. There are patients and supportive people in those networks who could enhance care by using Enlitic. https://www.enlitic.com
You might have noticed that I mentioned several Hungarians in this blog post. So, why stop now? There is a brilliant AI based drug discovery start up in Hungary called:
“Increase your laboratory success rate and reduce
time to trial with AI guided simulated experiments.
Turbine identifies complex biomarkers and designs effective
combinations by simulating millions of experiments each day.”
When I noticed Turbine, I did not have to think at all to know that this is brilliant! I wish this young company was advanced enough to permit patient side access to the system. Just imagine getting in silico hints about possible drug combinations that could help someone. Sometimes even drugs that are not cancer related can have a positive impact. Turbine, Oncompass and PentaCore Lab should create a partnership…
By the way, not only do patients need help finding the best molecular treatments, but people still need to find the best possible surgeons as well (etc.). I had to do such a surgeon search over ten years ago and the world’s best surgeon for the Hungarian patient was in the UK. That is still not an obvious thing that people can easily find online (You need statistics, like: How many such operations does that surgeon perform per year? How about his or her error rate? The top surgeon had a zero % error rate for a digestive system cancer and he used his own method that he was teaching during some of his operations… Go for that level of expertise, if you can! That is the safest.).
On top of that we also need insurance companies to realize that care is now global and this market has to be serviced globally, with locally acceptable fees.
Note: Oncompass Medicine also has a fee based, international cancer treatment research and cancer patient support service! It is the same kind of global cancer treatment research and cancer patient support that I am doing, but I do it for free. While I do this occasionally, Oncompass does this all the time and has excellent resources and a global network. If you can, it is probably a good idea to hire them. I don’t know how good they are. Let me know if you have any experience with them!
I am a big believer in self guided online learning. And so I coined the term: “self guided online health care”. Imagine having a personal robot that is connected to a medical AI. The patient could simply ask questions of the robot, it would connect to the AI and based on the lab results (a patient has at home or online), the AI could suggest different treatment options by scanning and comprehending the globally available medical research and treatment data. (I personally would prefer a more advanced, multitasking robot companion, or no robot, just the AI via my computer, tablet or smartphone.)
The Robot Will See You Now — AI and Health Care
A.I. VERSUS M.D.
What happens when diagnosis is automated?
My Game “Theory”
As I mentioned before, a global multiplayer online game could be developed for citizen scientists and medical students (even for doctors). By combining the available resources, a new level of information sharing could be achieved in a uniquely motivated network.
In both cases the data entry is one of the most problematic areas. Lab results should be both human and machine readable. People who e.g. play EyeWire or Foldit could be on-boarded in a new game that is about hunting treasures like life saving medical treatments around the world and building alternative treatment plans for patients. It is doable! And I am working on it! Let me know if you would like to fund it!
Precision medicine is simply not possible without participatory medicine. Demand better care! I know that it is easy to expect and really hard to do. But every little positive change adds to the chance of an actual paradigm change! I hope you find the right doctors and the most appropriate treatments for you, your loved ones and your community members.
You can connect with me via Facebook and LinkedIn. I am happy to help. No matter where you are from, no matter who you are: If you need help and if I can help, I will help! Pay it forward to others in need when you can. My time, energy and resources are limited, so please, respect that when you ask a question (note: I understand if you feel the need to explain the context). Thank you for reading my blog post! I hope I could help with at least a little something. Find many more blog posts on my three different blog surfaces in a multitude of subject areas! Live long and prosper! 🙂
Regina Saphier: Finding the Valley of the Dragon
Károly Patkó’s so called “San Vito” (see reproduction below) wasn’t painted in San Vito (in my opinion) and nobody ever noticed? I am sure the painting’s title would have been corrected by now had anyone had a clue about the real location. This is the story of my artistic process today, combined with the story of finding the correct place of creation of a well known Hungarian painting. Above you can see my own rendering of the Italian village where in my opinion Károly Patkó actually painted his picture.
My research process
You might think that I just grab my stylus and tablet, start ArtRage and begin to paint as if in a trans state. But that is not my process. I do a lot of research before I start sketching and painting. For example I research paintings, colors, styles, artistic periods and movements, artist bios, cities, villages, particular locations, spacial experiences and I compose my inspiration of the many impulses. I like to start painting when I can no longer wait to create because I so clearly see what I want to realize.
During such a research process in 2015 I discovered a specific location of a Róbert Berény painting and I created my own rendering from another angle, plus I wrote about the process. I keep making other discoveries as well. For example I discovered purely visually where Tivadar Csontváry Kosztka created two of his paintings in Taormina (“Full Moon over Taormina” and “Blossoming Almonds in Taormina“), in spite of the fact that this location is not in the visible vicinity of the ruins of the ancient Greek theater (that he also depicted there). Explore the location of the paintings via: Google Street View… Sadly the amazing pink villa is gone and the blue building is in ruins… The picturesque vista that once was is forever lost, but we have two paintings to help us remember.
Good things happen when a curious artist can not find the vista of a Patkó painting in the settlement stated in the original title
Recently I studied some Hungarian artists like Sándor Ziffer and Károly Patkó. After having noticed Ziffer in one of my paintings (I noticed his impact on my colors and atmosphere on my Roquebrune painting), I wanted to intentionally be inspired by Patkó, so I picked his “San Vito” painting. I looked at the particular “San Vito” via Google Street View (in fact I ended up looking at several places called San Vito) and I was surprised to realize that this Patkó painting has a clearly incorrect title. “San Vito” could not possibly depict San Vito!
My motivation to paint this village only grew when I had this in mind: I am the only one in the world right now who could intentionally create a somewhat similar digital painting from a slightly different angle in my own style. This is a familiar and reoccurring opportunity in my life! (Remember Monaco and Róbert Berény? I was able to find the place and paint it from a different angle. It was so much fun!) I just started to paint and research inspirational locations recently. How many paintings have the wrong location, the wrong title or no known and specified location at all (that could be discovered)?
(By the way, just as a side note: Károly Patkó died 75 years ago this April. 1941 killed so many talented artists I remember… Károly Patkó, Amrita Sher-Gil, Vilmos Aba-Novák, Virginia Woolf…)
Because I did not want to use the Patkó painting as my only visual input, and wanted to see the actual village, I kept searching for the real location. For some reason I was convinced that there should be a village that looks like the one on Patkó’s so called “San Vito”. Supposedly this has always been the title of the painting and that is really bizarre to me. Yet, there could be several explanations… for example Patkó used his own travel sketches to create his final tempera versions… it is possible that he himself gave the wrong title… hard to believe but possible… However, in many instances titles are given by other people once the artist is no longer alive… and art historians and art dealers are often superficial when coming up with a title… (eg.: in one case I could tell that a painting depicting a bridge in Paris with the title “sunset” was actually a “sunrise”… I just looked at it and knew instinctively that the title is wrong and it really was… I could show it on Google Street View within minutes).
How did I find the correct location of Patkó’s painting?
It was actually not that difficult, but I had to be persistent (and I was). The key components that I focused on were: a sea side Italian village among high mountains, apparently in a very narrow valley, a beach road on a viaduct, an isolated building on a very small beach and a particularly typical white building in the upper right corner with prominent terraces. (When you look at the most likely San Vito on Google Street View, you can clearly see that it is characteristically flat, broad, and the beach is rather long. Does not even resemble the village on Patkó’s painting. We know that he traveled to San Vito, it is in his bio, but the correct village that I finally discovered is not mentioned in his biographies that I looked at online.)
Next (based on the spacial experience on the Patkó painting, plus based on former travels and online research) I decided that while San Vito is at the Adriatic Sea, the place I am looking for must be on the Tyrrhenian Sea shore. I looked at several villages there, but I could not find it immediately. There were some similar places, but I knew that I had to keep searching.
I decided to stop looking at Google Earth and Street View for a while and went back to my usual inspirational Google Image search for the area to find the next best place to paint until I find the location of the Patkó painting. And interestingly that is when I stumbled upon a photo of Atrani on the Amalfi coast. And I knew immediately that I discovered the village where Patkó actually painted his “San Vito”! The aerial image was small, but the spacial structure was obvious.
The correct title should be “Atrani“… or “The Valley of the Dragon“.
This below is an interactive image, you can move it around to see Atrani today. I positioned it so that you can see the side of Atrani that was depicted by Károly Patkó. (At the end of this blog post I also included a composite image of Atrani in the past when the beach building was higher than the road.)
As soon as I had the time and as soon as I looked at Atrani from every possible angle, I grabbed my tablet, opened ArtRage and created my own architectural rendering of the village! It is a slightly abstract anachronistic juxtaposed homage to Patkó, Csontváry, Escher and Derain. It could be called: “The Turning Road at Atrani” (seriously, I hope you see these on Patkó’s painting: the turning road, the water and the gig with the three horses… and the man on the gig… and the water carrying figure on the road… and the people under the bridge-like viaduct… all references to Derain’s L’Estaque)… or “A Pink House in Atrani Below the Road” (because of Csontváry)… or “The Escheresque Cubes of Atrani” (Escher did actually draw Atrani and played around with the many cubes in the village)…
Coming up with a title and an artistic movement
You might assume that it is easy to come up with the right title of a painting, but that is also not the case. I spent hours finalizing the title… from the simple location name to the more magical one to the totally philosophical I had half a dozen different titles. At one point I called it: “Possibilism and Eternalism in Atrani”. And with that title I came up with a name for my own artistic movement: Possibilism. It exists as a cultural, human geographical terminology and basically covers the fact that geography is only a minimal limitation for cultural development. Cultural development is mainly determined by social conditions. When I transformed Possibilism into an artistic terminology I added the ever evolving internet and technology… plus I extended this terminology to geographically unlimited artistic creation (no matter where you are, you have the means to be anywhere online) and phenomenally flexible cultural evolution (you have the option of internalizing and even influencing another culture without being in that particular cultural or social environment).
I researched the village online. Initially the building on the Atrani beach was higher than the road, but the third floor was demolished after a while and in the 1950s the road was broadened and so the road is now literally above the beach building. While Csontváry’s beautiful pink villa in Taormina did not survive (and that made me very upset), Patkó’s beach house at Atrani is still there, even if a bit smaller and partly covered by the road. I remember how happy I was to see that in hyper developed Monaco the houses that Berény depicted were almost perfectly preserved in the harbor. Just the same, I am glad that the good people of Atrani maintained the beauty and authenticity of their village. This is where Eternalism joins Possibilism… Me culturally enhancing the story of Atrani from my living room couch (in another country) and also enhancing my own cultural heritage (Possibilism of the internet age) combined with the philosophical assumption that my digital painting’s possibility existed eternally in Atrani and only apparently came into being during the last couple of days (at least the possibility has always been there and only now do we recognize the manifestation … the same way the possibility of Patkó’s painting has always existed… think of a caveman sitting in front of a cave… that creature at the campfire cluelessly poked the building blocks of a futuristic society with a stick… the possibility of everything that exists today already existed within and without… the same way today we walk around knee-deep in yet unrecognized possibilities… for example we could ensure a dignified life to every human being alive, this is only a matter of joint mental effort, because the resources are there… the smartest individuals are however still trying to figure out how to enlighten all people about this and make the obvious possibility manifest itself as our everyday reality… clearly almost everything is dependent on our joint imagination… so, possibilities are not dependent on time, possibilities are apparently eternal, a time sequence is only relevant to the manifestation of the eternal possibilities… while space itself does not appear to be changing much during humanity’s existence… I could almost touch Patkó’s shoulder in Atrani while he is drawing, even though I did not exist yet when he was already dead… this is how I conceptualize my artistic Eternalism. When you notice a possibility and act upon it, you become the channel of manifestation of something eternally possible… ). But why don’t I stop driving the less philosophically inclined readers mad right here and right now…?
Pantkó’s Atrani, his inspirations, the secrets of artists and the ever lasting series of homages from artist to artist
If you compare Patkó’s painting with the real place (Atrani), you will notice that he changed the composition by eliminating the middle section of the residential layer… he virtually pushed some of the buildings from the left to the right to place them in the middle. He turned a broad landscape view into a tall portrait view. I think he did these because he found the series of arches on the left more interesting and wanted to make the middle section architecturally more homogeneous with the buildings on the right side. The mountain tops never looked like that in reality, he probably improvised, but the agricultural terraces above the buildings are correct. I am not sure about the colors of Atrani in 1931, but Patkó mainly opted for blues, greens, white and brownish colors… However, in this region blues and greens are less common on buildings. His version is in many ways removed from reality and yet the village is perfectly recognizable. While sketching Atrani he was standing above the viaduct, at or under the Collegiate Church of St. Mary Magdalene.
Artists influence each another and remember each other. I happily discovered how Derain’s L’Estaque painting impacted Patkó’s art… so, I disagree that his art was mostly inspired by the Italian tradition… Cézanne and Derain were definitely among his role models.
In my opinion this is not the only painting where he remembers André Derain’s The Turning Road in L’Estaque. Here are two other Patkó paintings that remind me of Derain: “Goose Girl by the Brook” and one of the “Subiaco” versions: women are washing clothes under a bridge and a coach driver is crossing the bridge.
Are we a 100% sure that Károly Patkó never went to L’Estaque? Alternatively: Where did he paint the “Goose Girl by the Brook” in 1928? His 1926 “Still Life with Apples” was clearly inspired by Cézanne… Of course one does not have to go to a particular place in France to be inspired by it… I know that. Patkó could have painted this canvas anywhere… even at Lake Balaton… based on a reproduction of Derain’s canvas. Anything is possible.
In his book (and in his two part BBC series) David Hockney talks about how old masters like Caravaggio used the Camera Obscura, concave mirrors and lenses when sketching and painting. There were trade secrets that made the artistic process more precise and faster. According to Hockney’s research concave mirrors were used as early as 1420… the artist worked in a Dark Room (Camera Obscura), while the model sat in strong sunlight outside of the Dark Room… Caravaggio apparently switched from the concave mirror to the more advanced lens in 1595… and in 1839 photography was invented. That means that between 1420 and 1839 artists gradually and secretly transitioned from freehand sketching to freehand tracing, and after 1839 artists regressed back to freehand sketching and painting that were the norm before 1420. Those who used concave mirrors and lenses were skilled artists, even appeared to be amazing magicians to less insightful people, and were most definitely shrewd businessman, deploying every possible contemporary technology to create the most lifelike and exciting images while optimizing their working conditions and maximizing their profits. Artists returned to the methods of the pre-mirror time period again as a reaction to the invention of photography. Today, in the age of digital photography, virtual reality, artificial intelligence and robotics, the task of the artist is no longer the creation of a lifelike visual experience, rather the task is eg.: the visual representation of human emotions. Impression, expression, fauvism, playing with light, color, atmosphere and space. In this age it is also absolutely self evident that more and more people are painting with digital tools. The intelligent and creative artist is open to every possible new tool his or her era has to offer. It is not the mirror, not the lens and not the digital tool that creates movements and marks. The artist’s personal and spontaneous neurology is what creates art in a larger social and cultural context, while channeling a universal and endless stream of possibilities.
Homage from artist to artist… a natural instinct that goes on forever. In many cases you don’t have to go to a particular location “to feel” or “to see” the place, especially today! However, the way I see it, the famous location of Derain’s fauvist painting is lost, just like Csontváry’s pink villa… these places live on in sensitive people’s unique art. Atrani (in the valley of the River Dragon) is a particularly lucky village that mostly maintained its original charme and is also enriched by artistic creativity.
As of today I am suggesting a new title and a new location for Károly Patkó’s “San Vito” painting. It should be called: “Atrani“.
Regina Saphier: Unique Digital Art Experience in Painting
Above: Vincent van Gogh: The Starry Night (1889) … I added his brush stroke details at the top and bottom of his painting. Notice the 3D appearance of the pigment. Some segments are even chipped… these details are beautiful and yet not observable by the naked eye… We need digital technology to show them online… I love to look at these details on the Google Cultural Institute’s Art Project page… click the image to be able to zoom into this beautiful painting and explore the texture. You can hardly expect any museum to let you touch a Van Gogh and look at it with a magnifying glass from up close.
This essay is about digital paintings, “classical” paintings, about the outdated, power and oppression based, elitist terminology of “uniqueness” and the elusive concept of “the original”… about what is “authentic” and what isn’t on the art market… about ever changing values, perceptions and the subjectivity of “market value”… about the best for a few, or the excellent for everyone… about the definitely original and the possibly original selling for the same amount on the global market… about Google Earth and Street View as artistic inspirations and amazingly as tools of an art historical discovery that I made during the process!
What matters is not the medium, not the surface… rather, it is the neural experience of the creator and the observer… The key is the merging and the synergy of experiences.
What is original? Artistic versus market value.
In my humble opinion, art “happens” between the brains of the creator and the observer, more specifically, between their brains, neural networks, synapses, neurons, the physical features of photons and the surface of the medium. The medium of representation or creation itself is marginal when it comes to artistic quality. According to David Hockney (one of the most important contemporary artists today), it is “the hand” that matters. I say, it is the personal neurology that matters. I think we are talking about the same thing, I am just a bit more scientific. And that personal neurology is what makes something original to the owner today (not the canvas and not the oil). However, the untrained (and sometimes even the highly trained) observer is easily fooled by skilled forgers and so it is really hard to say what it means to have the original. It appears that believing that something is original satisfies most people. So, it is the belief that matters.
Estimating the market value of art is a completely different problem. Or is it? It is not about how artistic something is, not about the fingerprints of the specific artist’s hands (it is not about the artist’s hair in the oil on the canvas), not about how original it is as the result or product of a creative process (from a qualitative point of view). The financial or market value depends on the joint narrative, the PR of the seller and the psychology of the buyer.
An original oil on canvas Van Gogh on the museum wall shows less of the artist’s “fingerprints” (or hair for that matter), than a HD digital photo that permits unbelievable zooming into the artist’s brush strokes. I am sure Van Gogh would love to try digital painting after seeing his own brush strokes digitally magnified. He would see how brilliantly expressive it is. Also, many of his paintings would still be visible instead of being under another painting because he had no money for a new canvas. I would rather have more Van Gogh paintings, even if digital! Again, it is not the medium, it is the neural and visceral experience that matters!
So, we have belief and narrative behind the artistic and the market value. Both are phenomenally subjective. Humans are able to form beliefs, values and narratives in relation to digital art and anything else in life. It is how we function. Both traditional and digital art depend on acquired preferences and value systems. In the age of Bitcoin you can easily attach market value to digital art. In the digital age you don’t necessarily have to own the “one and only” original.
Originality in music, literature and cinema
Think of music
If you want to think about the incomprehensibility of the term “original”, think of classical music, think of Bach and the Goldberg Variations (a variations based composition that Glenn Gould recorded twice, both before and after he stopped playing to a live audience… he stopped because of his fear of airplanes and hatred for his audience… the youngish version was recorded in 1955… next he stopped flying in 1962 and recorded the old version in 1981 in a state of the art studio, just a year before his death). You can obviously not have Bach in your living room to play for you. You would need Glenn Gould to come and play if he were alive, but he is as dead as Bach at this point. Plus, in the end even a Glenn Gould concert was hard to find… even when he was still alive.
With visual art, next to having Van Gogh sit in your garden painting your almond tree (impossible), the next best thing today is owning his original Almond Blossom painting (also impossible) he created for his brother’s bedroom when his child was born, a few months before Van Gogh died.
In music, what is original? Bach playing his own composition for you directly? Not possible. Glenn Gould playing his own youngish interpretation of Bach in a concert hall? Young Glenn Gould’s impetuous studio version? His meditative version he recorded as an old man? Or is the original the music scores noted by Bach’s hand on paper? And how do you define originality when you purchase the Goldberg Variations by any artist as a file? (I always preferred listening to classical music alone with my eyes closed, to sitting in a concert hall in bright light on an uncomfortable chair with strangers I never wished to see… except of course that unique Sviatoslav Richter concert in Graz, Austria two decades ago… he played in a darkened room at night and only a candle was burning on the piano… that was all the light during the concert… I loved the experience!)
While I developed this essay, when I reached the idea of music, I opted for Glenn Gould as an example instinctively. And suddenly I found that he actually also contemplated musical and any kind of artistic originality and authenticity, precisely because he basically became the technical director of his studio recordings after he discontinued his concert pianist career. Interesting to find that he also came to the conclusion that there is a “pathetic duplicity” when people go from hysterically celebrating a painting as original to hysterically hating it once it is scientifically shown to be a forgery. I agree with him. While I dislike deception, aren’t overpriced art, luxury product marketing and romantic love all based on (self) deception?
Think of literature and cinema
What is original and unique? Take Ingmar Bergman’s “Scenes From a Marriage”. Is his script “the original” that he wrote within a few months? His miniseries that he directed? The book that contains his story? The stage adaptations? Initially, all people had in the past was the story teller, and later the theater with people on the stage. Next, as more and more people could read, there was the book. In the modern days the movie theater was invented. With the book and the cinema the story teller and the actor did not have to be present in real time. Today you don’t have to be present in the movie theater, you don’t even need to watch television, you can listen to an audio book, read on your kindle and watch films from files at home. What is original and unique? In every case it is your personal experience that is unique, as you lose yourself in the artist’s projected experience. The medium does not dominate your experience, even if reading a book, listening to a reader, or watching a film are different types of experiences. Independent of the medium there will always be your very personal experience.
Is something original if you have to pay for it (a little or a lot), or is it still original when you get it for free in an era of unconditional basic income in the future? Keep thinking: What is really original in an endless universe? Just how original is Earth itself in a Galaxy of hundreds of billions of stars, in the Visible Universe of at least a hundred billion other galaxies?
Power and leadership in the digital age
Originality and authenticity are outdated social constructs of a snobbish and power hungry elite who are also digital immigrants and often technophobes. The digital natives only nowadays begin to have a voice.
Here are the words that represent and describe the old and fading concepts of originality and uniqueness in my opinion (in art market terms of paintings these are not about talent, nor about personal creativity): money or funds (financial value, financial agreement based on an object that was created only once by someone well known and celebrated), status quo, elitism, common belief, (artificially created) scarcity, narrative (real or manipulated), PR (always manipulated), subjectivity, impressionability (lack of knowledge), self deception, perception, attitudes, the illusion of objectivity, illusion in general, changeable social and personal values, social and individual psychology (the need to fit in and/or build an identity), acquired preferences (based on own networks), oppression, exploitation, despotism, wealth, egotism, selfishness, questionable power and influence, competition and success of the few at the expense of the many, emotions and ever changing culture(s). This is where we are coming from.
As the digital natives with new, enlightened and timely values become leaders, these words and concepts will hopefully begin to fade during the next couple of decades.
The equal market value of the “definitely” original and the “probably” original
Let me give you a completely contemporary and fresh example how passing time, changing values, skillful PR, impressionability, acquired preferences, egotism and scarcity create inflated market “value” and also increase artistic “value” perception. It could be any artist, so the names in the story are not important. My goal isn’t gossiping, my goal is to be able to give you a raw example.
The artist was born in Hungary, yet she is regarded as one of the most important Indian painters (her mother was Jewish Hungarian, while her father was Punjabi Sikh). She died young in India (she was only 28) and most of her paintings are either in museums or in family collections. Most of her paintings are in India. Few of her paintings are in Europe, but these are in much better condition, due to the climate. For decades her art did not have much global market value (her highest prices a few times were around a few hundred thousand dollars), until an ambitious, talented and middle aged Hungarian gallery owner decided to acquire her well documented self portrait from a Hungarian family member (the old man, who as a little boy knew the artist, took care of the painting for decades, and this ensures authenticity… this historic detail adds value). The gallery owner took the painting to Sotheby’s and set down with a dedicated professional team. The networking started and a well crafted PR story unfolded targeting rich Indian men…
The created narrative was that here is this phenomenally talented and sexy, pretty young thing with her red lips and beautiful gaze who died in her prime after having studied in Paris, and just before she could reach her artistic peak in India. The narrative worked, the painting was sold for nearly 3 million USD in New York in 2015, surprising even the extremely ambitious seller and the highly experienced team (and also angering the son of the old family member who sold it to the Hungarian gallery owner). And the power game begins, behind the scenes for now… to the point of the gallery owner supposedly trying to suppress articles on the internet regarding the record sale! (Just how much of an ignorant and egotistic despot are you… man…?) And to the point of the original owner’s family supposedly taking legal action against the gallery owner. How lovely! It is morally puzzling to me why the gallery owner did not offer a joint sale of the painting in the first place. It is also unclear to me why the original owner did not go to Sotheby’s directly… (I mean, he is fluent in English.) Just why do I have this uneasy feeling that this story is based on exploitation, even if in local terms the original owner probably received a nice amount of money…?
This is what happens when the market value of something is artificially and suddenly inflated. This has nothing to do with artistic value. This story of “value creation” unfolded without the knowledge of the supposed global “authority” of this particular lady artist’s work in India, a family member, who has never met her in person. He was stunned when he got the news. An old, mediocre artist, who is basically recycling his aunt’s art… So, when suddenly the aunt’s self portrait was sold for millions of dollars in the US without his knowledge and without his “royal” assent, he found himself insignificant (despite his many inherited paintings by his aunt suddenly having a record market value… his inherited collection in India was suddenly at least six times more valuable, because of this one sale in New York that he did not even know about).
Next thing you know, another self-portrait by her, out of nowhere in France pops up and now the old Indian relative is asked for approval before the Christie’s auction in London (probably via e-mail). To the best of my knowledge (and rest assured, I have not read this complex story anywhere, rather I harvested information from my network) he simply looked at a photo of the newly discovered and completely undocumented self-portrait (it wasn’t published anywhere and nobody knew it existed) and gave his immediate validation that it is definitely original. Just like that. Long distance. Almost like a clairvoyant. WOW! This, and only this nuance made the major sale possible in this case! He has not known about the painting beforehand, he did not hold it in his hands, he also isn’t an art historian, neither does he occupy himself with the chemical laboratory analysis of the pigments or the review of X-Ray imaging results of the deeper layers of the painting. In the golden age of technology, he simply looks at a photo and “knows”. Yeah, “right”…! And the painting that was not even documented in this so called connoisseur’s detailed and heavily illustrated book about his aunt (full of her letters and paintings, and her narcissistic father’s photos), was sold for over 2.5 million USD in London in 2015.
Without the sudden and rather superficially issued consent by the Indian relative, because this painting was latent until recently (unlike the other, well documented and well known painting sold by Sotheby’s in New York), nobody could have sold it in a major auction in London at Christie’s. Her market value was absolutely expected to go up, but not as suddenly and not as high as this. But now her art is at the top of the female Indian painters’ market value short list (within a few months), based on two early self portraits sold in the US and in the UK. The definitely original and the probably original sold for almost the same amount, there were only two hundred thousand dollars between the two final bids. Imagine when the old owners of her paintings begin to pass away in Europe or when some of her more mature work hits the market in India (her paintings can not be taken out of India, so once you take her art from Europe or from the US to India, that is it, it stays there).
Here is the extra grotesque part!
There is a heavily researched painting in Hungary that was acknowledged to be her painting by many experts and even a family member. The painting was exhibited in one of the major museums in Hungary. All sorts of tests were done, including X-Rays, different types of photographs (ultra violet light, infra red light, high definition, etc.), pigment analysis and so on. Yet, it cannot be sold at any auction in New York or London, because get this: based on photos alone (!) the Indian family member decided years ago that it is not his aunt’s work. Again, just by looking at photos. He never examined the painting itself and never explored the research material. But even if he were to examine it in person, he admits that he is not an expert. He does not issue an expert’s statement, no matter what. Yet, a multi million dollar sale depends on his superficial and subjective opinion. Is this what should determine what is original or unique today? Definitely not! Yet it is what is happening.
Technophilia and Technophobia
“Technophilia (from Greek τέχνη – technē, “art, skill, craft” and φίλος – philos, “beloved, dear, friend”) refers generally to a strong enthusiasm for technology, especially new technologies such as personal computers, the Internet, mobile phones and home cinema.” (wikipedia)
“Technophobia (from Greek τέχνη technē, “art, skill, craft” and φόβος phobos, “fear”) is the fear or dislike of advanced technology or complex devices, especially computers.” (wikipedia)
Technology is constantly evolving while the human intellectual and aesthetic evolution appears to be slower. Most people lack the intellectual independence to make up their minds about something new (and also about most of the old as well). People seek out opinion leaders (not necessarily true and reliable experts) to know what is original, what is valuable, what is authentic. That is rather sad but true. Most people aren’t independent thinkers, yet many assume an individualistic pose.
Anything can be artistic or original (if you like). If you have an oil on canvas Hockney, a montage Hockney, or a digital painting of Hockney, all of them were created by his hand, his brain, his neurology. And in each and every case the medium is also part of the end result (but only one part… it is not the key aspect of the artistic value and should not be a key aspect of the market value either in the twenty first digital century). Emotionally the impact will be the same if you have the right values and a high quality product. It is the values, the psychology, the narrative and the quality that matter, not the medium. You will see and feel what he wanted you to see and feel… a UK landscape in LA’s bright light for example… no matter what the medium is, if the product comes with a high quality.
Today, a digital painting’s market value, for example a monumental digital Hockney’s (even if it is made of smaller parts), might be determined by the fact that he has decades of contemporary success behind him, that he was invited by the Royal Academy of Art in 2012 to display his digital paintings and that each monumental digital painting was printed only once, so only one exists or only a limited number of them exist (depending on the agreement). It does not matter if it was painted on canvas, paper or on an Apple iPad or on a Samsung Galaxy Tablet Note 10.1 or a Note Pro 12.2, or perhaps on a jaw dropping Wacom Cintiq 27QHD Creative Pen and Touch Display for 2800 USD… plus 400 USD for the Ergo stand and 100 USD for a more capable Wacom pen… all together my dream tool is approximately: 3300 USD… I think that is without software… (note: software for android devices is much cheaper than for windows or apple products).
A demo of how the Wacom Cintiq 27QHD is used in animation:
Digital artists, who come after Hockney, don’t have to walk the same path, because he represents the transition from traditional contemporary art to the digital contemporary realm. The fact is, anyone could reach some level of artistic value. However, if you have some sort of classical visual culture (you don’t have to be academically educated, it is sufficient if you were surrounded by classical art or if you trained yourself visually), a person might be able to create much stronger and intellectually much more stimulating digital paintings, compared to those who were only exposed to the “aesthetics” of online games (note: there are very few aesthetically excellent online games). On top of this, the artistic and market value also depends on the cultured and/or sensitive audience or observer, again, a highly subjective component in the values game. Some are receptive, some aren’t. Some people are in touch with their latent inner artist, existing somewhere deep down, and some are completely out of touch with their creative emotional selves.
It is puzzling that most contemporary artists are technophobes…
Uniqueness in the digital age
In the digital age, when humanity attempts to make the most possible quality items available to the most possible people (like the cheap, yet excellent ArtRage software for android is a celebration of the long tail economy, while the Samsung Galaxy Note 10.1 or Note Pro 12.2 Tablets are also excellent), “uniqueness” becomes a highly questionable term.
Uniqueness in economic and market terms (not in artistic terms) speaks about the assumed needs of the elite, about privilege, power, money, wealth, or in other words about inequality, the oppression, exploitation, enslavement, dependency and suffering of the masses. (However, today people are learning at a rate like never before, so change might be on the horizon.) The rich buys “the one and only” at the expense of the poor. Something that is unique is a beautiful thing from one point of view and a very dirty one from another. Holding onto the shockingly expensive and to the traditionally unique represents an attachment to the despotism of an outdated and unenlightened era. A rich person is not better, nor more deserving than a poor person. An artist using oil and canvas is not a better artist than one using digital tools to paint and provoke some sort of emotional impact.
Hockney did not come from a privileged background. For a long time, among many things, he used oil. Today in his seventies as a famous and well to do artist he is also creating digital art. He is still undoubtedly creating Hockney paintings. The old medium does not dominate the artistic value, so it should not dominate the market value either. Of course the most sophisticated forgers are able to show people that even the artist is obsolete, when someone makes a skilled copy and nobody notices (only an Artificial Intelligence tool will be able to distinguish the original from the fake after a while). I know that “cultured” people are attracted to owning the original, but I don’t think that this is an inborn and necessary feature of humans. This is something we learn. So, this is also something that we can unlearn or reform.
Apparently it is the experience that matters. The artistic experience is formed in the observer, in his or her neural network, based on the available information (based on learning and feeling). How immense this artistic experience is depends strongly on the narrative. Art is a mental and social experience, embedded into an ever evolving narrative.
David Hockney talking about his digital art
About my digital art
I suddenly and only very recently started to learn the art of digital painting. By the end of July of 2015 my most amazing dog-sister passed away and my hunger for emotional expression resulted in sudden bursts of artistic activities. I finally gave in and accepted my best friend’s suggestion that digital painting was invented for me. He kindly lent me his Samsung Galaxy Note 10.1 Tablet and introduced me to ArtRage, a phenomenal digital painting software. Practicing graphic art is a new phenomenon in my life. Finding flow beyond blog writing to forget about loss… Turning pain into digital paintings to definitely see the beauty of life.
Two weeks after my brilliant dog’s sudden death I posted my first “presentable” digital painting (my third digital painting ever) on my facebook wall to a select few friends. It was a freehand digital drawing and painting based on my spring time smart phone photo of a nearby salmon pink Bauhaus building (note: there will be a composite image of my learning process later in this blog text).
Apparently it is a general practice today to paint from digital photos. In fact I just read a few days ago that hundred years ago Pierre Bonnard took photos of his family home and went to his art studio to work where several canvases were stretched on the walls (not on regular stretchers). This is how he created his uniquely intimate paintings. He also did not determine the size of his painting until it was completed (note: in the windows version of ArtRage one is able to enlarge the canvas if necessary).
You can look up and observe the old, but renovated Bauhaus building that I painted (find it on Google Street View if you like). It is 3 Napraforgó Street in Budapest’s second district (Napraforgó means Sunflower), very close to my home (I like to walk there, the entire street is part of a special housing project from better times in this country… it feels a bit like it wasn’t even in Hungary, rather somewhere in the UK… you almost expect a character like Belgian detective Hercule Poirot to appear). On my digital painting I intentionally made it look like the building was located somewhere on France’s Mediterranean coastline, because I used to own a Róbert Berény painting that he created at age 18 in Monaco at the very beginning of the twentieth century. I loved it. I always fantasized about one day painting rooftops for example. In fact “my art rage” started five days after the emotional trauma with my attempt to draw a “tree still life” on a tablet (to see how it works) and next (two additional days later, on July 27 of 2015) I attempted to recreate the atmosphere of my long sold work of art by Berény (an oil on cardboard) that used to hang in my bedroom in my former apartment. (Note: see the composite image of my learning process below.)
Frankly, after I had a professional photo reproduction on my wall for years, I don’t feel any real difference. Initially, it was painful having to sell the original, but I was happy to hang a high quality photo reproduction on my wall in the original frame. It is the emotional composition, the sight, the style, and the colorfulness that I like. I simply don’t care anymore that it is not “the original”. It is still unusual that I own a large and high quality photo reproduction like this one right here on the wall (I am sure, I am the only one with this experience). It is even more meaningful to me that I created a remake of the 1905 painting, because I discovered new details on the painting itself (there is not only a black winter coat, but there is also part of a blue winter coat visible in that same window). And not only that! I even discovered on my own where the painting was created in Monaco and I created my own rendering of the same courtyard as seen from another point of view! This is new information that could enrich our knowledge of Berény and his art. I will tell you the story (in words and in pictures) later in this blog post… Wait for it and read on to better understand what I am doing!
My evolving artistic self
I think I am approaching my personal style that I feel like calling “Neuro Fauvisme Digital” or “Neuro Digital Fauve Expressionism” or “Digital Neuro Surrealism“. As in my inner city photos, the same way on my digital paintings there are no people (also no animals except a hidden and small female black dog in each and every painting, representing the highest levels of loyalty, independence, curiosity, tolerance, love, devotion, truth and intelligence). I work with high tech to create images that resemble the art that was created over 100 years ago in Europe, because that is what I like. I am looking at Google Street View, walking through cities of Europe, finding landscapes and architectures that speak to me and I depict them manually, yet digitally, as if I walked through old towns and villages during summer siestas in 1904 or 1907. These images are my inner walks. My introspective nature is reflected in them.
Despite the high tech that I am using, there is nothing modern (no modern technology) on my digital paintings. I depict cities, homes and structures that contain human communities, that were created by people. No cars, no motorcycles, no digital displays, no traffic lights, no airplanes, nothing like that. Today, I am painting a pre-digital world, with a digital medium (but this might change as my art evolves… I am going to paint as long as I enjoy it). Until now I didn’t create visual art, because I was uniquely surrounded by hundreds of paintings created by (in large part female) artists who were active before W.W.II. Painting traditionally did not appear to be a particularly unusual or special activity to me. However, painting digitally in a pre-digital style felt fascinating to me. My evolving art is a colorful reminder of the Belle Époque before WW I., just when modern technology started to overwhelm us. I love modern technology (I am a female technophile), but I find my flow in taking a paradoxical break from it and wandering (off) visually, mentally and emotionally in(to) a long lost world. Any decent introvert will understand what I mean.
Look, I know that one can’t paint for 30 years within 3 weeks. I know I am a total beginner. People still like to compare my pictures, atmospheres and motives to paintings by Chirico, Escher, Matisse, Hockney, Berény or Csontváry and the like (interestingly and tellingly: not one female is listed, ever). The thing is, I don’t paint like any of them. I paint like me. No need to copy anyone, beyond obvious learning reasons. Yet, I was definitely shaped by the art that I observed throughout my life. I am just learning to paint (on my own), and see what happens. Stimulating (in)sights… loving life… optimism… yet a melancholic observer, a dreamy outsider… My images carry my contradictions. The traveler who is in one place all the time lately.
I write and paint as if I lived in California or New York in the US. Yet I live, write and paint in Budapest, Hungary, Europe. My subjects are located thousands of kilometers away in eg.: the Mediterranean region of Europe. I absorb, read, write, paint, express and display digitally. When you look at my paintings, imagine them as large printed colorful canvases in a foyer or lobby of a lively, elegant home, hotel, museum or restaurant in San Francisco, or on the wall of a magnificent loft in New York. This is what I have in my mind when I am between two paintings. But much more importantly, when I paint I have nothing “on my mind”. It is exactly why I paint. I like to be lost in space and time. Writing is more of a left brained flow experience, painting is more of a right brained flow state. This is how I find my path, my truth… via a whole brain experience. This is my way of celebrating life. I never party, I don’t use substances, I am not dependent on a defined group of people and their opinions. I do my own things. I am my own person. Yet I am highly connected to the world online.
What is unusual is that I have been doing this sudden artistic activity for a few weeks only… yet, it feels like it has all been waiting there inside of me to suddenly happen. I don’t even have to think about my concept when you ask me. It’s there, even ready to be written, as you can see.
My learning process
It pleases me enormously that I finally have an outlet for my serene self. My blogs are full of pensiveness. Painting balances me and helps me show my true inner range. And in surrealism anything is possible… you can have sunlit nights, with dark sky and bright, colorful walls.
Before I start drawing the sketch, I spend some time looking for my next subject for a few days. I pick sights that give me a particularly good feeling. I select subjects that I suddenly start seeing as a painting.
Three weeks into the self guided learning process this is what I produced:
The first painting I posted on August 2nd of 2015 (the salmon pink Bauhaus building with the cherry tree) took me two days to create (I was still learning the software… had to get used to the digital logic of drawing and painting). The last one that I posted on August 22nd of Lake Como also took me two days. You can see the difference in complexity, yet both took me the same amount of time to create. It is unbelievably cool to experience what one can do within three weeks just by simply wanting to create images, by being dedicated and open minded. It still takes two days to complete a picture, because I am still learning while doing and I want to do well. Each time I wish to create something presentable in the end.
I skipped “the cube drawing phase” of learning (that usually takes months in a regular and formal drawing class… I don’t like boring training sessions… I did the same self-willed skipping while learning English… and yet I am able to write blogs in English about basically anything as you can see), and I do the practicing during the visual creation. I keep drawing the lines, until the “buildings” end up in the right position. I keep searching for the form, the shape, the depth, the perspective. I keep going back and doing it again, until I feel happy with the position and the composition. In a way I almost draw multiple pictures in some areas of the surface, until I end up with the final product that I like to look at, that shows the coherence I was looking for. This is why I call it eg.: “Digital Neuro Surrealism” (note: we all have a typical, personal handwriting, and I believe we all have a typical drawing and painting style that naturally happens while practicing). I don’t walk the academic path, it is dead boring to me.
I walk the neurological, instinctive path. Sometimes my frustration is enormous. I sit there and say: “Why can’t I draw?” or “I can’t draw!”… Because I see that it is wrong… so, I remove the specific area and do it again and again, because I know that I should be able to do it. I know it is possible, I just have to keep doing it. And suddenly I like it and I am happy and proud that I suffered through the frustration and that I persisted. When the sketch is done, I start painting the buildings on another layer (on my “Monaco – Rue des Iris” painting I put everything on the same layer and that is not the best approach with the digital medium… it is a good idea to use the separate layers, but technically it is more complicated… especially in the android version of ArtRage, because there the layers are not constantly visible while working)… and so on. Typically, I am not satisfied until I am done with the painting. There is a point where I feel that it is “ready” and I am happy with it (and I feel that I no longer wish to perfect it). I particularly like red buildings (red will be hard to print well, but I still like it).
During my discovery of the digital art realm I came across David Hockney’s digital paintings and listened to him as he spoke of his initial skepticism… Soon he realized, that this is a very serious and quick tool. I agree! Of course he is lucky that he has helpers dealing with the printing and mounting process. Perhaps one day I am going to print my paintings on canvas and hang them on the walls of my apartment along with other art.
Google Earth and Google Street View as brilliant sources of visual inspiration
Sometimes I point randomly onto an area of Google Maps or on Google Earth and zoom in on the Satellite Image of a particular city or village near a large body of water. I “take a walk” in places that I already have been to in the past, like the Côte d’Azur (I took many photos of the landscapes). When I discover the right place to depict, I walk around in Google Street View to compose my next digital drawing and painting. Luckily, due to my many travels, I have a realistic feeling of many places on Earth. I know how it feels to be there.
What is unique about this process, is that Google Street View is created from an angle that would be humanly and practically impossible to work from. Google Street View cars have a long pole on top carrying complex cameras that take multiple images at once as the car moves along the way. This is how the stream of image bubbles are created around the world. If I wanted to assume that position, I would have to sit on top of a ladder on top of a car and would have to maneuver the car back and forth while also painting, and that in the middle of the road. In my opinion Google Street View is a creative and open minded artist’s best friend. I don’t know if anyone is using it like I do, but it was a natural choice for me.
My digital or virtual self and a possible future
For many years I worked on an all digital writer self… I absorb knowledge digitally and I spread knowledge digitally via my blogs. Now I have another opportunity to be 100% contemporary and digital. I look at Google Street View with my human brain and eyes and I create a digital painting manually, filtering the sight through my personal neural network and neurons. Often, in the middle of the painting there is the road, representing life as a continuum and I take you into a (modern) technology free world that actually does not exist anymore. At this point, my freehand digital paintings look like illustrations in children’s books and I really love that. This is all so unexpected and gives me so much joy (after the sadness of loss of a loved one and beyond the understandable frustration of learning).
For an added texture I might one day attempt to 3D print my freehand digital paintings instead of simply printing them on canvas. If you look closer, ArtRage is able to detect your manual movements, hand pressure, etc., and is offering many tools and settings that give you the ability to create real texture. (One is able to add much more texture, I just opted for lighter touches.)
Painting digitally is more spontaneous, flexible, there is a lot of freedom, it is much more intuitive with all the tools compared to traditional painting. However, when I work with the digital stylus, I never copy or paste, I don’t put photos into the file, I don’t use digital shapes, I make everything possible manually (freehand).
I think what we need to do, is no longer a comparison of traditional painting and digital painting. We are already at the point where we should rather ask questions like: What would you see as original, a manually yet digitally painted painting by a human (printed professionally on real canvas), or an oil on canvas directly but created completely by an artificial intelligence driven robot without zero human intervention?
And at this point I think I just invented the AI navigated robot, that (instead of printing or even instead of 3D printing) looks at your finished digital painting file (not a computer generated image) and carries your exact movements (by learning the patterns of your personality, emotions and neural activity), painting your image move by move, on a canvas that you can hang on your wall, adding amazing extra texture to your digital painting.
So, as you can see, now as I am beginning to teach myself to draw and paint digitally, I did my share of thinking about this art form and field. I hope some or most of this essay was interesting to you.
Rest assured that this art technology will evolve and in a few years people will begin to acknowledge freehand digital (drawing and) painting as the serious art form it already is.
Remember, that in life and in art: It is the experience that really matters!
A small detail of my Lake Como painting:
By the time I completed this blog (on August 31. of 2015), I also completed a new painting. Here are three versions of my “Le Pin Parasol”:
This is a detail showing the manual/digital brushstrokes on my Le Pin Parasol representing the sea and the trees (note: I opted for homogeneous waves, but you can go really wild if you change the settings of the tools):
I painted this sight based on a photo on Pinterest. There wasn’t much info… I only knew that it was somewhere on Capri, in Italy. I could see that the tree was a Stone Pine. I had a good feel for the entire spacial experience. As usual, I got curious and used my almost savant like skill to find the original location (note: I used to be the nightmare of real estate agents… I could find their advertised homes based on the smallest spacial information… just seeing a small part of a city, like a rooftop is enough for me… on several occasions I would wave at the agent from the specific building’s door while he or she would wait for me at some neutral corner… finding things on Google Earth is something I also like to challenge my friends with… it is so much fun!). I used Google Maps and Google Earth and within 5 minutes I discovered the exact place. I zoomed in and out and explored the area. If you are like me, you can find it based on my painting in 5 minutes too. (Here is the solution if you can not find it, but first try if you have the time… if you don’t, just highlight the section: Via Krupp)
But here is the really amazing discovery I made during this process!
I used the same savant skill and tools (that I described above) to find the place in Monaco where Róbert Berény painted his Monaco houses and rooftops in 1905. I created the digital painting remake to learn (note: the Samsung Galaxy Tablet that I am using and the ArtRage version on it are Android based), plus discovered the place on Google Earth where he created his painting. The address in my opinion is 23 Boulevard Albert 1er, Monaco. I think Berény was standing on the terrace in the courtyard (he was facing south on a sunny winter morning very close to the sea in Monaco) and he painted the north facing walls and rooftops of a few villas on Rue Princesse Antoinette (unless he took photos as many of his contemporaries did). If you look closely, even the characteristic glass bricks are visible from space. (See images below for a better understanding.) From Rue Grimaldi one is able to see parts of the buildings on Google Street View. The building that is yellow today used to be peach colored a few years ago … and before that it could have been pink or red. A lot has changed in over 100 years in Monaco… and yet the atmosphere is the same in this courtyard.
Young Berény (only 19 at the time) was standing behind the inner white structure (on the left side, as seen from Rue Grimaldi below) on a huge terrace and faced the smaller buildings (like the yellow one on the right side)… The colors were different in the past, plus his imagination also played a role. Of course some of the buildings were slightly reconstructed since the original Berény painting was completed in 1905, but the place is 100% recognizable. (I posted images of the original painting at the end of my post.)
I am assuming this is a historically significant discovery, this is why I felt that I should publish it immediately as part of my digital art related blog post. I used to own the painting, I created its remake digital painting as part of my recently started learning process and I spotted the special place while exploring the area for further artistic inspiration via Google Maps, Earth and Street View. I painted a street approximately 500 meters from this location in August 2015. I was getting closer and closer and suddenly I had the exact place. I felt obligated to share my discovery with everyone who is able to appreciate it.
Thank you Google! I love technology! I love art! I love to write! I love to paint! I love to do research! I love to discover! I love the experiences!
Here are a few images to help you understand my research result:
In case my fascinating story that I discovered the place of creation in Monaco of a Hungarian Fauve painting (by Róbert Berény) that I used to own wasn’t exciting enough (as part of this blog post in English and as the main topic of my latest Hungarian blog post), let me add this:
Gergely Barki, the number one Berény expert in Hungary was in Monaco at the very same time looking for the location where Berény created another early painting depicting houses in the Port of Monaco. We weren’t aware that the other person is exploring the area (him in person with his lovely family, and me online while painting and doing my detective work).
As it turns out, we have met 15 years ago in my own former home where my Berény painting was on display at the time. After returning to Hungary, Gergely was stunned when he accidentally found my blog (during a Google search) with the images of the courtyard that he also photographed. As he wrote he was only a 1000% sure that it was the same courtyard after he read my blog.
I’m thrilled that the story just keeps getting better! He gave a talk at a press conference of the Virág Judit Galéria in Budapest today on September 21 of 2015 and Gergely incorporated my findings and blog post into his presentation.
He was so enthusiastic as if we were related and I love that! It is so nice to correspond with someone who had a very similar experience, and who is able to appreciate my results. I wish I had an enthusiastic sibling like him!
Regina Saphier: Sunny Nights: Tesla PowerWall
Thank you Elon Musk for giving Hungarian citizens a possibility to economically refuse the planned new Russian Nuclear Power Plant that the idiotic Hungarian government is planning to build in Hungary for exorbitant amounts of borrowed money (borrowed from the Russians of course… while people have no jobs…).
When a political election did not stop the nuclear power plant idea (it did not), when the EU is impotent to stop it (it is), you can always count on Elon Musk to do something that changes the game and gives even individuals power in every sense of the word!
TESLA’s home (and industrial) solar energy storage technology is already something that the middle class could afford even in Hungary and without government subsidies. (Because never expect this government to support something that makes sense… in present and in future tense.) Imagine people building new homes, purchasing solar panels, a TESLA POWERWALL, and living off the grid from the first day in their new houses… no need to have a contract with a utility company that provides more expensive, nuclear power based electricity or “natural” gas… It is a smart investment economically and ecologically to spend money on a PowerWall (eg.: at home) or on a PowerPack (let’s say, by the II. district in Budapest).
These batteries (their industrial versions) will also enable small and local energy businesses, even local governments to provide extremely affordable day and night Solar based electricity to financially less powerful clients. And I could go on and on about how it is a good idea to build this technology into existing homes and institutions as well… And we would have cleaner air as well… because heating homes with fossil fuels is one of the major sources of pollution… as are exploding and burning nuclear power plants… And how about finally running air conditioners with Solar energy (day and night).
I am for the TESLA POWERWALL. I support the TESLA POWERPACK! My secret dream: Elon Musk for Hungarian president… or at least a similarly intelligent and talented person. Game change: on!
And the punchline: 2 billion PowerPacks could make the entire world 100% Solar and renewable powered within a decade or two, and Tesla has a factory sized product for this: The TESLA GIGAFACTORY (that is obviously powered by renewable energy and Tesla PowerPacks).
Regina Saphier: Writing, Inner Speech & The Borg
The adventures of our inner voices… in the age of artificial intelligence, direct brain communications and global online networks…
I swear I thought I am going to write about writing as a manifestation of my inner voice (silent thought processes that only you are aware of and only you can work with… until you write things down, speak them out loud or get them out of your mind in some other way with technology… no I am not joking), but I ended up in a completely different direction… this is why I write, to explore what is in there and what is out there and what is in between…
Writing is listening to my inner voice/speech (in a healthy way)… to my own thinking… It is a manifestation of my reflective capacity, my consciousness… and reading is listening to someone else’s inner stream of ideas (alongside your’s)… If you don’t realize that you do this, pay attention to yourself more. Just as many people are not aware of their inner imagery when reading a novel for example, the same way many people don’t know that they are running a narrative of their own reality in their heads… It is “on” so much so that only people well trained in meditation are able to turn off the inner voice, the inner speech, the random ideas, feelings and reactions… and there are mindful people attempting to guide and manage the inner speech and voice… to use it efficiently, even creatively (like me) and not let their inner processes ruin their experiences. Introverts are more in tune with this inner world.
Radio, Skype, Intimacy
I love the radio show: This American Life. I love many of the stories people tell or read on that show. Some are fiction, some are nonfiction. I think it is one of the best radio shows in the world. I always loved radio done by people who truly love to listen and tell stories.
I just noticed that a “voice only” skype chat with a friend and listening to “This American Life” stories on my computer or smartphone… these experiences have something in common. Perhaps it is intimacy. Films and video chats on skype never have this depth. When you see people, when you see yourself talking to someone, when you know you are being watched, when your conversation partner knows of being watched, you both remain highly self conscious (different people on a different level), even if you are old friends. When you listen to radio or to someone’s voice via skype (or via phone, if you do not have to hold onto the phone physically… remember how your hands could get tired of holding that thing… or your ears could hurt… these physical reactions keep you self aware), there is a depth of intimacy that you can never reach with the moving image and with a phone in your hand. The moving image is wonderful, but even if you put the camera right into someone’s bedroom and into their faces, the moving image can never be as intimate as hearing a person talk “only”. I am sure you can feel how overwhelming it is when some people film and photograph everything… and how calming it can be when you can just listen (listen to the other and to yourself) and relax. Of course photography is a brilliantly expressive art, and yes some images are worth a million words, but most images can never outperform a good voice chat online… and yes, I also love in person chats, of course, but those are different (due to the physical and the visual elements, it is simply harder to allocate all of your energy to the spoken layer). I love films, but I might opt for a good radio program instead.
Relying on Your Hearing Only
It is similar to blind people having unbelievable hearing, to the level of bats. When you “only” listen to someone, you become an emotional bat, navigating blindly in an emotional cave and relying on your listening skills and instincts. I believe this is a good way to improve your intuitive capacity. You don’t see with your eyes, you see with your mind’s other “eyes” and you go very deep, really fast, if you like. Your brain suddenly reaches a deeper level of listening and closeness.
This is similar to people sitting in completely dark rooms… they become highly intimate even with strangers (there is also less material for judgement… you are more able to feel close to another human being…). It is almost meditative when you listen deeply. Effectively, you can become a better listener if you only listen to people via skype and via radio. It is interesting to experience different modalities.
I just realized, when I am writing, I am turning my inner radio on… I start listening to what I am thinking closely and I make it visible on my computer screen (would be nice to skip this part, the typing and the reading by making the process more direct). I ask myself questions without asking… the questioning of the self and the excavation of thinking processes and opinions are embedded in the process of writing. Writing is not typing. Writing is listening to myself and mapping how I am relating to the world. During writing your limited consciousness stops being a small mental container and turns into a portal for your deep mind… and the deep mind of sophisticated internet users is different from the mind of unconnected individuals who are not mindful. In the distant past when people were listening to their own inner narratives they had no real time options to see how that inner narrative related to other people’s deep mind and to facts.
Reading as Listening
Reading is listening too. Because after I posted this blog note, you started to read it (most likely) silently. I effectively speak to you silently… it is like asynchronous telepathy… you are listening to my inner voice in your head with some delay. When you start thinking about my ideas in your head, you virtually engage in a silent conversation with me. I only know it when you write back, or speak to me, but even if you do not, the conversation happens, even if “only” in your head (you will respond and resonate even if you do not write to me). Every person reading this blog conducts a secret parallel conversation with me in a hidden dimension of our universe. I believe that writers are essentially and primarily skilled inner conversationalist, explorers and listeners. Writers are even able to converse with people in the distant future (and with people in the past, when reading). I am writing for my own pleasure, to see what I think, but still, thank you for the conversation, now that you let me enter your mind with my inner voice and speech. It is my inner narrative that will survive as long as my writing is being read (or absorbed in some other way in the future).
The Future of Inner Speech and Mental Transfer
Perhaps one day people will no longer speak nor write to one another but simply use “technological telepathy” (just made this terminology up, because I know that the basic technology is already a reality in this area) to transfer this inner voice directly from mind to mind or from mind to computer (just like mental images are now recognized and reproduced by dedicated technology). It will be just as simple as leaving a message on an answering machine, or even easier. However, when I look at the difference in precision, I am thinking: how are we going to be able to be as precise and as nuanced as in writing? Are we going to think our ideas into a file and edit them by thinking about our thoughts? Isn’t it interesting to think about this? And when uploading our entire mind on a computer, are we going to edit out the personally embarrassing bits? And what are we to do with criminal minds?
Are we going to get help from AI to take our inner narrative to the next level? Will an AI companion read our minds to help us know what we think? Will an AI help us learn the things we need to know about the world and ourselves silently? Is it possible that we are becoming The Borg… a community of minds directly connected? Everyone hearing everyone else… Are we to become one mind? How are we to remain individuals in such a network? How are we to protect our minds from other people’s evil thoughts and destructive inner speech? Who is going to be in control of our minds?
Video: The AI based holographic Doctor teaching a former Borg, called Seven of Nine (a human being rediscovering her humanity lost during her childhood) on the show Star Trek: Voyager
Futurist Zoltan Istvan‘s transhumanist dream (and he is not alone with this dream) to upload his mind might just be the only reality for people in a machine age of constant learning, collective knowledge, the internet, robotics, space exploration and AI. But that won’t solve his fear of death, because he will still be gone one day… His knowledge, personality, and inner speech will melt into the collective. Humanity as The Borg…? “Seven of Nine”… “One of Seven Billion” today… But just how valuable will our minds be when AI systems will become more knowledgeable and more creative than people? Only we care about our ephemeral minds… Would you like your brain to be placed in an individual robot? Perhaps many people would be ok with that… Is your identity related to your body or your mind or both? Are YOU a mental process? Will our fear of death be replaced by the feeling of being intellectually and creatively obsolete when AI technologies become smarter and unfollowable for a human individual and even for humanity as a whole?
See? This is what I end up with today when I am thinking about writing as inner speech, a special way of self expression and listening. Our inner monologues will be highly and directly interconnected dialogues or group conversations in the future and that is probably an understatement of how our communications will be unrecognizable… and yet it will be natural even with technology, because our brains have the capacity to adapt. Writing and the spoken word might become obsolete sooner than we think. This will be the age of really big and fast understanding of unimaginably big “data”.
Articles I read mostly while I wrote the above post:
Telepathy is now a thing thanks to technology
Brain decoder can eavesdrop on your inner voice
Artificial Intelligence Outperforms Average High School Senior
Direct Brain Communication Between Humans Study Replicated
Controlling Genes with Your Thoughts: New System Regulates Gene Expression
These People Want To Use The Internet To Live Forever