Double Loop at the Cleveland Clinic Raises Important Points about Medical Waste

Sarah Kabot and Marianne Desmarais, Double Loop, Installation view at the Cleveland Clinic. Photo credit: Joseph Minek. 

The chance meeting of Sarah Kabot and Marianne Desmarais at Cranbrook might have been a lark. What emerged was a decades-long collaboration.

Marianne Desmarais answered a classified ad that Sarah Kabot had placed in the fall of their first year together at the graduate-only Cranbrook Academy of Art. It seemed like a bizarre request.

“I was looking to invade someone’s studio space while they were not present,” Kabot, who earned a Master of Fine Arts degree in Fiber, says with a laugh.

“I didn’t look at it that way!” Desmarais, who earned a Master of Architecture, interjects during a recent Zoom call.

Kabot explains that, while reorganizing Desmarais’ studio, she wanted to find a new way of seeing common objects.

“I went through by hand and catalogued items in her studio while she was not present,” she adds. “I ultimately made a book about these items.”

That sense of revealing what’s hidden would be a recurring theme for the pair throughout the years—and into the present day when a request for proposals from the Cleveland Clinic’s Art Program and Office for a Healthy Environment (OHE) was posted.

The studio “invasion” led to a long and fruitful exchange of ideas—even as Kabot moved to Cleveland to take a position as chair of the Department of Drawing at Cleveland Institute of Art and Desmarais relocated to New Orleans to take a position at an architecture firm.

Years later, it would be Desmarais who reached out with an offer.

“I was saving pieces from (an architectural) model I was making and mailed them to Sarah,” she recalls. “She started a collage and we sent them back and forth a half-dozen times.”

Desmarais credits this exquisite corpse-style exchange with sparking a realization that making art was her true calling.

“Shortly thereafter I did a residency at Banff (Centre’s Artist in Residence Emerging) and I married an artist,” she observes. “Some time passed, but, after that first collaboration, I realized I wanted to pursue an art practice.”

It also cemented for the pair that they complemented each other in ways that would prove advantageous when producing work as complex as their first large-scale collaboration: a sculpture that would hang above the entryway on St. Clair Avenue at the refurbished Westin Hotel in downtown Cleveland in 2014.

“I didn’t seriously consider the request for proposal unless Marianne was interested,” Kabot recalls about the lead up to winning the commission. “We relied on our (previous) trade in drawings and exchanged drafts that way. There were a lot of phone calls to find a shared path and through that process we started to define a notion.”

The homing instinct of birds inspired the sculpture, titled Terrella, a Greek word signifying small world. It also references Cleveland’s early days as a port, where ships would dock near to the location of the hotel.

“Travelers would be navigating to this spot,” Desmarais says. Mapping the natural world ultimately figured into their choice of a bird’s-eye view of the Cuyahoga River drawn in perforations on a metal scrim. It gathers ideas on nature and technology, two currents that run through their work.

In 2020, a second opportunity to collaborate appeared—this time, due to one of the more revelatory pairings in corporate art. The Cleveland Clinic’s Art Program and its OHE share a roof at the Stanley Shalom Zielony Institute for Nursing Excellence. One is charged with curating the vast fine art collection owned by the Cleveland Clinic and the other is responsible for the environmental commitment the hospital giant has undertaken in recent years, including figuring out a pathway to carbon neutrality and the elimination of waste heading to landfills by 2027. The two departments launched a joint program that produces art at an important intersection—one that looks at the enormous resource consumption of healthcare institutions.

Kabot and Desmarais won this, the second commission in a series which called for a reimagining of medical waste. In this case, the pair proposed a sculpture fabricated from hundreds of pounds of plastic tubing and valves from intravenous (IV) kits that had gone beyond their expiration date. Sometimes these kits can be donated to hospitals in the developing world, says Emily Szramowski, OHE administrative program coordinator, but these were past that date, too, and were headed for the landfill.

The resultant piece, Double Loop, was installed recently, soaring above the nursing students who enter through a second-story atrium in the Zielony Institute.

“I think what this piece can help us understand is the unseen volume it takes to run a hospital and make people healthy,” says Sienna Brown, the newly installed curator of the art program at the Cleveland Clinic.

To its credit, the Clinic is attempting to address the vast stores of waste that are produced by health care. In addition to its zero waste goal, it has a full-time staff person devoted to “greening” their supply chain, says Szramowski.

For Desmarais, the crush of solid waste moved from abstract to reality in September when municipal garbage pick-up in her hometown of New Orleans ground to a halt in the wake of Hurricane Ida.

“I’m living through it,” she says. “We should be using less or reusing what comes from our hands.”

“This is a story of brilliant advances, with a lot benefit, but then we see what comes after,” she continues. “It’s the endeavor. It requires this running ahead, but also this circling back. We know if healthcare is working to maintain our lives and our wellness, they fundamentally should not be impacting the environment to make us unwell.”

Szramowski says that the Clinic annually diverts 8,000 tons of medical waste, including IV kits, through nonprofit groups like MedWish International, and with private sector companies like Cardinal Health and Mentor-based STERIS.

Waste as magical discovery

What I find magical about (Double Loop) is how effortless it all looks,” says Brown.

This was no small feat given that each of the two fabrics weigh nearly 200 pounds. The Art Program’s installation crew worked forty feet above the ground for two, ten-hour days rigging cables and a fine steel mesh that Kabot and sometimes Brown affixed the art to. Planning involved engineers, architects, and the artists devising a system to support and give the work its tapestry shape with a slight twist.

The results are a triumph—two translucent, colorful fabrics attached to exposed structural beams inside a light-filled space that has giant east- and south-facing windows fronting on Euclid Avenue. Sunlight illuminates sections and end points at differing times of the day. Some of the larger tubes were spray painted a sepia tone and arranged in floral shapes, while thinner, pink strands were arranged to drape below the surface like sea grass, for example.

“We had to solve how to put a forty-foot textile that looks diaphanous, but is heavy, into the air,” Kabot says.

Their strategy involved Kabot clearing her garage at home to test ideas and build it out in segments. Desmarais built a computer model that arranged the valves into color sequences. They found out, when they cut the tubes, how light reflected from the edges like facets in a gemstone and interacted with the colorful valves. The artists think of the tubing as having a fiber-optic quality.

“Cutting things free and cutting them up and reattaching them into forms was the beginning of seeing in the familiar unseen qualities,” Kabot says.

“We didn’t want folks to think about IVs and think about a loved one,” adds Desmarais. “I’ve been a (hospital) patient and it can be debilitating to remember all of those contraptions. Some of the apparatus had nice color, so we tried to amplify how things might (look) in the natural world.”

Double Loop is the second commission in the series between the two offices at the Clinic—the first commission was 2019’s Makeshift Sanctuary, by Cleveland artist Dana Depew, featuring a brightly-colored reuse of boxes that hold pipettes, those slender glass tubes used for measuring liquids in medical laboratories.

“Health and sustainability and art are interrelated,” comments Szramowski. “I think the collaboration will be getting bigger, in more public spaces, with more talks around why it’s relevant and important.”

Brown expects that the pandemic, and perhaps the sudden appearance of climate-related disasters, will shift the nature of the series going forward.

“COVID has changed the conversation around health care,” she concludes, “and I don’t think anyone knows yet how. (Ahead) we have several large projects, and I think it will be exciting to see what artists will come up with.”