On the Outside
by Megan Fileman


My sculpture is intended to illustrate the difficulty of giving support and comfort to someone when they are suffering, particularly when their experience is something that you can sympathise with but are unable to empathise with - because you yourself have not experienced it.


A Chilean friend of mine recently wrote to me (Chile suffered an 8.8 magnitude earthquake just over a week ago)


He wrote:-


“Here in Chile is like Hell on earth, after the earthquake there has been a lot of riots, people destroying supermarkets, stealing everything they can get their hands on... In many places there's no water and no electricity... The government gave the Military full power of certain areas in Chile because the situation was simply unbearable, people are acting crazy.
An uncle of mine lost his house, the earth just open itself and the house was cut into two... My sister had to evacuate her apartment, because there was water running down the ceiling and apparently it had structural damages. Luckily my mom’s house is in perfect conditions and my father's apartment has only minor problems. The only thing that keeps my worried is that there are 6 friends that I haven't heard of since the earthquake... I hope they are Ok but at this point I don't really know what to think.”

As a friend I desperately wanted to say something to help, to comfort him about his friends and give him hope. However, I felt that anything I could say was empty, coming from the UK I had no experience of what it must feel like to be in a situation like his.

This difficulty I felt in communicating has made me think about how a similar problem may arise in a clinical situation for example when a person receives bad news about a loved one, or themselves. A patient may even open up and tell you about difficulties they are having elsewhere in their lives.  During these conversations the difficulty of saying the right things to support them may be even more complex- as they are not even a friend. You may only have met them in a few 10-minute consultations. Each individual may find different words and actions comforting, and judging how to react to each individual would require excellent listening, assessment of mood and character and an understanding of their situation and how the patient is asking for your help. 

In my sculpture the individual in blue is the person living through a difficult and emotional time, the glass around them is representative of the barrier that can arise between people when they have traumatic and emotional experiences. The red person is representative of me/ a healthcare worker/ a friend trying to help. They are trying to care for the person inside the glass but have difficulty reaching them in a meaningful and supportive way.

Megan Fileman

Whole Person Care 2010  



28 November 2010 - 21:18:37
"Hi Megan, I am midwife pratitioner in London and I am a postgraduate student at the University of Bedforshire. Your artefact is inspirational and your reflection made me lost of words as you yourself have explained. I agree with all the words in your reflective analysis. I am from a troublesome country, Sierra leone. I have had really traumatice experiences that i felt at the time no word can help. I was a haematology nurse specialised in the care of blood cancers such as; leucamias. myelomas, anaemias and so many other blood disorders that most times require bone marrow transplatation after courses of chemotherapy. I looked after a 16 year old boy until when he was terminally ill at the age of 18 and died. He went into multiple organ failure and had poor prognosis. The medical team decided that for the sake of alleviating longterm suffering, he should just be on pain control. Basically to leave him to die peacefully. All chemtherapy treatment stopped. He knew what was happenning and ask me to give him shoulder flap (the things that nurses put on to identify their positions). A week after that he passed away. His mother was so fond of me and herself and the young lad will always request me caring for him. So to say to ehr mother how i felt was impossible in words. so i had to give a photographic representation of my emotions. I drew myself sitting with head facing down on a table and arms sourounding all parts of my face. I was totally out of words there was nothing I could have said to her. she did understand how I felt about the loss. Mahmoud"


07 March 2011 - 22:12:23
"I found your work very moving, particularly because of your reference to your friend in Chile. I think that the sculpture really demonstrates well the difficulties that can exist in communications between the doctor and patient. Furthermore it made me think about how isolating it could be as the patient struggling to communicate your problems or feeling misunderstood by you doctor and the people around you."

J Smallwood

17 March 2011 - 12:02:38
"I like both the simplicity of your sculpture, and the emotion of your reflection. Striking and effective. This is something which shall doubtless affect all of us at some point (if not already) on either side of the glass, but previously I had barely thought about it, only in passing thoughts. I think you've done a really good job of expressing the feelings you felt in your own situation while making me think about it from theirs too. We have such sheltered lives."

R. Walker

17 March 2011 - 12:02:02
"This sculpture illustrates a very 'real' problem that many people experience both in normal and clinical scenarios. The simplicity of the sculpture that conveys such a complex issue makes the viewer really relate to the feelings of isolation and the difficulties that others feel in trying to reach out to people in need."

Philippa Donnelly

13 June 2011 - 18:25:28
"I really like the simplicity of this piece, yet it still gets across the message. I totally agree that it must be really difficult for doctor's to get patient's to open up sometimes, and when they do, the struggle to understand, having had no experience of it themselves. I feel this simple piece illustrates this perfectly, especially through the use of a glass as the barrier because this shows how the doctor can see the pain of the patient but cannot connect with them or empathise."

L Kelly

19 March 2012 - 11:25:01
"This piece really reflects the emotional barriers that have to be overcome in the doctor patient relationship. I think it is true that patients find it easier to communicate with doctors who can relate to what they are experiencing. The piece shows how as much as the doctor can try to connect with the patient, the patient can still feel alone and isolated."

R Huxley

19 March 2012 - 11:25:01
"It was recently said that 'no-one wants an ill doctor', this beautifully presented sculpture made me rethink that and consider the idea of the 'wounded healer'. This is someone who can really empathise with patients and lift up that glass barrier separating them. Everybody can experience hardships in their lives and it's good to know that perhaps my own experiences could help me become a better doctor some day, helping patients who feel alone and isolated realise that we can give them support. "

Chloe de Souza

19 March 2012 - 11:25:01
"I really like how simple yet powerful this piece is. It shows the difficulties within doctor-patient relationships of having to overcoming emotional barriers, and also how sometimes people can't offer the help that someone truly needs, because they have not experienced that particular situation before. "

Emily Kirkham

19 March 2012 - 11:25:01
"Despite being so simple, the glass symbolises a very effective barrier of communication and understanding, that I believe, is more common in the doctor-patient relationship than first thought. I like the way, that to further emphasise this point, the doctor is 'above' the patient, accentuating the barrier that exists between them. This sculpture highlights the importance of overcoming these barriers and being able to empathise with the patient, in order to provide effective care - something I hope I will be able to achieve in the future."

Ella Rogers

19 March 2012 - 11:25:01
"This piece immediately grabbed my attention through its simplicity yet powerful message. The piece illustrates how sometimes no matter how much you want to understand and empathise, it can be so hard to know how if you yourself have not experienced what the person is going through. This illustrates a problem that can occur in the doctor-patient relationship, and needs to be overcome in order to achieve good quality care."

Eliane Blows

19 March 2012 - 11:25:01
"This piece for me illustrates how many interpretations there can be for what the artist intends art to mean. However, it is also moving in its universal simplicity, and is a clever metaphor for the barrier between doctor and patient. It immediately has impact through the contrasting colours and stances of the figures, and reflects physically how difficult it is for doctors to empathise with patients who are very different to them, despite trying very hard to provide care and support."

Jon Allington

19 March 2012 - 11:25:01
"This piece of work really captured my imagination. I felt that the lack of identity and features on the models allowed the piece to be seen in so many ways; such as the emotional barrier between patient and doctor, it shows that there are points in which the barrier that doctors encapsulate round there patients can stop them from supporting them during emptional turmoil. I hope that when I become a doctor that I manage to balance this well. "

Anna Armstrong

26 October 2017 - 21:05:47
"I found this piece very relatable and applicable to the daily life of a doctor. The glass acting as a metaphor demonstrates how it often feels hard to get inside the patient's perspective while consulting and you are left feeling like an outsider. The separation of the two figures represents this well and I like the simplistic style. I think this sculpture accurately depicts the difficulty as a doctor of being able to empathise and provide support to individual patients. The variability in how patients react and respond is challenging which is often made harder as the patient is in situations the doctor themselves will never experience first hand. "


28 October 2017 - 07:31:04
"A very thoughtful, insightful and excellent piece of work. The artwork exemplifies an issue that is very much prevalent in everyday healthcare work. I am sure it has conveyed the message that you intended. "


29 October 2017 - 15:16:36
"This is a very emotive piece of art. The contrast in shapes of the two models wonderfully illustrates the two perspectives of Doctor and patient. The Doctor so desperatly wants to help the patient, but struggles to penetrate the barrier that so many mental illnesses create. I can already relate this to a number of patients that I've met, who isolate themselves from any help available."


29 October 2017 - 17:56:30
"This piece of art work was really thought-provoking for me. Even before their careers, doctors must have seen at least a hundred different patients but no amount of exposure will make easy emphasizing with patients. The doctor may be trying his/her best to reach the patient but the patient, as in the picture, may just not be cooperative or out of reach. I love interpretations can be inverted to have the doctor in the glass, isolated from friends and family because of the duties as a doctor. "

Ahmad Khalaf

29 October 2017 - 21:54:58
""As soon as I saw this picture it drew me in. even though it is very simple, I think it is an excellent way to describe the doctor-patient relationship. The use of the glass barrier is a particularly clever symbolic representation of the fact that doctors can see the pain but they are not always able to provide treatment; this emphasises the importance of empathy towards patients, the picture illustrates how the patient still suffers when the doctor sympathises only. I really like this picture because even the colours(red and blue) are chosen in a clever way; they symbolize the oxygenated and deoxygenated blood."

Ashvin Seetul

29 October 2017 - 22:01:20
"Food for thought here. As a medical professional, you will have to deal with hundreds, if not thousands of news breaking to patients and loved ones. The approach the doctor uses is like a glass pictured above, which is fragile if anything is misjudged in breaking the news, but every situation is unique and with different opacity and size of glass. A special technique needs to be mastered to ease the process of lifting the glass without cracking/shattering it. It's a skill that only a few fully master by the end of their career, and even then, human emotion is still vital to level with them. "

Emily S

29 October 2017 - 22:03:40
"I think this is a very moving piece as it really clearly shows the difference between sympathy and empathy- the person is trying to get 'in' and help the other person, but they are only able to get so close as they have not been in the same situation themselves. I think it is very accurate how the patient is completely surrounded by the glass as often problems completely engulf a person and they feel unable to get away. "


30 October 2017 - 08:22:45
"Simple, yet effective. There are times when it's difficult to connect with someone because you may not know exactly what they are going through, or because making such a connection could be painful and so a person may avoid making such a connection to protect themselves, or because there are times when a person who is suffering may put up walls and not allow anyone to make a connection with them."


30 October 2017 - 19:40:48
"This cleverly thought-out artwork is simple yet it excellently conveys the very understandable and relatable struggle that friends/healthcare workers can face when trying to support and comfort someone who's in a situation unknown to them. The glass is a clear visual representation of that barrier and the difference between being able to sympathise with someone and being able to empathise with them. "

Izzy B

30 October 2017 - 19:50:05
"This piece, although relatively simple, displays huge and relevant meaning in a very visual sense. It depicts one person, who may be experiencing some sort of emotional trauma (as symbolised by the colour blue), and another person on the outside who looks as if they are attempting to connect with them. This attempt is unsuccessful due to the presence of a physical glass wall which may represent the emotional barrier put up by the isolated person."


30 October 2017 - 19:50:11
"I think this piece demonstrates the isolation that those suffering from depression must feel when it seems as if no one understands what they are going through. The glass separating the two figures could represent the perceived boundary between the patient and others that appears impermeable even though it is clear to see the suffering being experienced through it. This scene also shows how interaction with and sympathy for a patient may not necessarily translate into any improvement of mood or mental state of the person suffering from emotional or mental trauma. "

Mya P

01 November 2018 - 08:06:45
"I think this piece appears to be simple to the eye but in fact has a very powerful meaning behind it. The idea that the person in the glass feels isolated from the outside world may be due to an emotional barrier they have put up. The friend appears to be trying to offer support and help to the person suffering, but does not this seem to be working. This proves how even though people may have support to help them through difficult times, they may not want to accept the support. This happens especially when the person supporting they friend has not gone through what the sufferer has and cannot relate to the emotions they are feeling (eg: the death of a close family member)."

Rajan Mann

04 November 2018 - 09:25:35
"This piece is extremely thought-provoking due to its simplicity allowing many interpretations to come to the surface. Personally, I feel that the bleak background shows the hopelessness of the person inside the glass, and the impossible situation the person outside the glass has to reach inside. It shows that no matter how much somebody on the outside wants to help, it is ultimately up to the isolated individual to help themselves up."

Lily Lee

06 November 2018 - 09:10:10
"This is such a simple yet thought provoking and powerful piece, at a time when mental health is at an all time high and the NHS are struggling to deal with helping so many individuals I feel like this artwork accurately represents the struggles that doctors face when trying to help somebody with a mental illness recover. The fact that the glass is clear represents that the patient can see you but they are enclosed in a world of their own. The choice of colour of blue can represent that the person is feeling depressed and the red could represent the frustration of the doctor/family member in trying to help them get better"