Living bone

A major issue in public engagement is the balance between presenting information and stimulating curiosity.

Polly Nash and Jo Cammack - recipients of a Science on Stage and Screen award from the Wellcome Trust (with additional funding from Yorkshire Arts) - faced this issue in a short film about osteoporosis, Bone Orchestra. Since the film will be shown mostly in transient spaces - libraries, doctors’ waiting rooms - Polly and Jo are aiming to stimulate an interest in bone and osteoporosis, rather than deliver facts and figures. "People aren’t necessarily going to watch the whole thing, because they may just be passing through, so first and foremost we want to intrigue them and get them thinking about bone," explains Jo.

"We felt that the best way to engage a wide audience would be by using people as a point of access." To this end they spent months talking to affected individuals. "They told us what it’s like to have osteoporosis and how it’s changed the way they live. Things that used to be high up on a shelf they simply can’t reach now because they’re shorter. They have to move mirrors because they’re too high. They say the onset of winter and autumn is a real worry because you slip on leaves. It’s all these strange little details that engage you with the experience of osteoporosis."

The film will look at three people with osteoporosis: a woman of 85, the stereotypical osteoporosis patient, a man diagnosed in his early 40s (unusual in that while one in three women over 50 will be affected by osteoporosis, only one in 12 men suffer) and a woman who was diagnosed at the very young age of 15.

Rather than spelling out the experience of pain caused by crumbling bones, the film seeks to convey the experience more indirectly. "We filmed the man, David, in a hydrotherapy pool at the Osteoporosis Clinic at the Northern General Hospital in Sheffield," says Jo. "You see his body, moving slowly underwater, with all this light dancing on it, and you hear him talking about his pain, saying, ‘when you live with pain every day, this is just bliss, to be able to suspend yourself in water’."

The choice of language is also an important factor. "If you start talking about osteoclasts and osteoblasts, for example, it can be quite distancing. People start to get distracted by the fact that they don’t understand something, rather than being captivated by the images," says Jo. "Then you have to think about how to present that text in an intriguing manner." Sometimes, as in so many creative and scientific endeavours, the answer comes unexpectedly. "When we were filming David in the pool, we arranged words and phrases - describing factors influencing bone density, such as age, hormones, smoking and so on - on acetate on the wall of the pool. Then someone dropped them in the water by mistake - and it looked great. We filmed words floating on the water, almost seeming to appear out of nothing because they’re on clear plastic."

Likewise, the choice of images is obviously crucial. "Bone is living tissue," says Polly. "It’s not this lump of concrete that you hang clothes on as people often think. It’s constantly being broken down to release calcium into the body, or to form new bone if there is a break. Your skeleton is recycled every ten years in terms of the mass of bone. We wanted to find images that would be analogous to this endless remodelling."

Polly and Jo found their analogy in the endless reshaping of the coastline by the sea. There are also some striking visual similarities - caves in a rock face resembling the internal structure of bone.

The collaborating scientist on the project is Dr Michael Horton. His group at the Bone and Mineral Centre, University College London, is using high-power microscopy techniques to investigate what happens in bone cells - in particular how cells communicate with each other during physical strain, or exercise, which can enhance bone mass.

Most drugs currently used to control osteoporosis, are about reducing reabsorption of bone, rather than stimulating bone formation. The film conveys this partly through images of people exercising - running and dancing - and also through a schematic that Michael draws on the sand for David. "That’s the only bit of real explanation or information about the science itself. We’re also going to print an accompanying leaflet that will reproduce and give simple descriptions of specific images in the film. It will also have points of contact for more information, so they can get in touch with support groups. We keep reassessing what we’re doing, and trying to make sure we’ve got the balance right, so that people will understand enough and at the same time become inquisitive and want to question and find out more."

See also

• Science on Stage and Screen: Background information and details about this former Trust award scheme
• Bone Orchestra: Further details on this Science on Stage and Screen award-winning project
• Press release (31 January 2003): Wellcome Trust charity announces a major new £1 million science and art award scheme