A peek inside the world of medical illustration

Émilie Lacharité is Digital Content Editor at CMAJ (she is also a trained medical illustrator)

Perhaps you’re familiar with the profession, but many are not. Medical illustrators are educated in human anatomy and life sciences and have the skills and technical training to communicate scientific concepts in a visual way. They create animations, illustrations, 3D medical models, virtual simulations, medical games, interactive educational modules, and more. There is one accredited program in Canada, Biomedical Communications, at the University of Toronto (my alma mater).

Last week, I attended the Association of Medical Illustrator's 69th annual conference in Rochester, MN, home of the world-famous Mayo Clinic. Rochester is a tiny town but it boasts an impressive variety of leaders and experts in diverse fields. Our group of 400+ attendees got to hear from some of them, as well as other awe-inspiring speakers from around the globe.

There were so many great talks and I wish I could address them all but, alas, here’s a quick flyby:

Dr. Christopher Moir, pediatric surgeon at Mayo Clinic, gave a poignant and emotional talk about the successful separation of conjoined twins Abbigail and Isabelle Carlsen, which took place back in 2006. He explained that multiple imaging techniques ultimately still fell short in detailing the intricacies of the girls’ anatomical abnormalities (such as a common duodenum, and a messy network of bile ducts) in a way that was clear enough for the surgical team to feel confident with performing the operation. Medical illustrator Michael King was asked to step in and worked closely with pediatric radiologist Dr. Jane Matsumoto to provide a series of extremely accurate illustrations of the twins’ anatomy (see one sample below). These provided a crucial surgical planning tool for the team of 70+ people who separated the twins. The poster-sized print-outs were then used as reference on the day of the surgery. “Medical illustrators saved the lives of two girls”, said Dr. Moir.

Mayo Clinic conjoined twins' illustration

Again on the theme of medical planning tools, Mayo Clinic pediatric neurosurgeon, Dr. Nicholas Wetjen, explained a new approach used for surgical treatment of craniosynostosis (the abnormal fusion of one or more bones of the skull in infancy). A medical 3D animator (whose name I unfortunately did not catch), uses CT scan information from a child’s malformed skull, recreates it in 3D software, and essentially provides a virtual platform in which surgeons can break down the top portion of the skull into pieces - think puzzle pieces - and reconfigure the skull into a more natural shape. They then map out the new skull pieces with lettered codes on the child's skull and perform the operation. Their research on the technique has found it yields a better shape result with a single, shorter operation. Win, win. More details here.

Lee Aase, Director of Social Media for Mayo Clinic, shared his insights on the importance of being out there (here?) in the world of #socialmedia. He said the networking that happens on social platforms is what drove Mayo to the top, despite it being in a small city. And with its relatively minimal cost, the return on investment for being involved in social networking has the potential to be quite large.

In their talks, MK Czerwiec (aka Comic Nurse) and Johns Hopkins medical illustrator and instructor Lydia Gregg, shared with us the power of comics in medicine. Although they have been in the field for a long time, graphic novels and comics are now being recognized as an important and effective modality for knowledge transmission, especially for taboo or touchy subjects (e.g. bipolar disorder), the younger crowd (e.g. asthma education, retinoblastoma), or even for global topics such as a graphic novel on pandemics, published by the CDC. Comic Nurse MK Czerwiec, who is in fact a nurse, now does workshops with medical students to unleash their inner graphic art talent. For more on graphics in medicine, check out graphicmedicine.org.

Avid Twitter user Jen Christiansen, Art Director of Information Graphics at Scientific American, shared her insights on the difficulties of visualizing complex scientific information for both an educated lay audience and an expert audience within the same graphic. Not an easy task but she always finds beautiful solutions. She also challenged us to rethink how we depict the brain, an organ that may be better understood as a functional map rather than an anatomical one. See the Human Brain Project for more information.

There is a fascinating community of science+art lovers on the Internet. Some of the insiders helped us explore this world. There was Glendon Mellow, social media guru, talented artist, and blogger for the Scientific American blog Symbiartic, a lovely fellow with an under-appreciated sense of humour. There was also Julia Buntaine, founder and editor-in-chief of online magazine SciArt in America, who seems to know everything about science-based art. Follow #sciart, #scicomm on Twitter and check out scienceblogs.com for more.

A handful of fine artists shared with us how they have discovered a love for anatomy and medicine and garnered attention along the way. There was Lisa Nilsson, of the Tissue Series fame, who recreates anatomical cross sections entirely out of rolled-up narrow strips of paper (a technique called quilling). Artist Danny Quirk uses liquid latex and markers to dissect with a paintbrush directly on human subjects, giving us a dramatic peek inside (see below).

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Then, if all that wasn't enough, our minds were blown by a couple of speakers who have worked with the likes of National Geographic, BBC, Discovery Channel and, oh ya, George Lucas. The first was Viktor Deak, paleo-artist, who, as he put it best, "likes to make heads". In his small NY City home studio, he creates anatomically correct forensic reconstructions of fossil hominids, both in sculpture and as paintings or murals. This video pretty much sums up the greatness that is Viktor Deak.

The second mind-blowing presenter was Andrew Cawrse, who gave a few talks and workshops. Andrew started out as a visual effects guru working with the greats in California and while doing so he became obsessed with sculpting human anatomy. He eventually left Hollywood (!) in order to dedicate himself to teaching and his anatomical modelling company. His Sculpting for Surgeons class teaches cosmetic and plastic surgeons to pay attention to the aesthetics and proportions of anatomy as well as its function. "Be addicted to the human form," he said, "in order to recreate its beauty."

9 thoughts on “A peek inside the world of medical illustration

  1. cgosling

    Medical Illustrators are interesting and talented people. All plastic surgery residents should be required to take a twelve hour course (Minimum) in the basics of proportion, drawing, sculpting, molding and casting. I taught such a course for 40 years and the doctors sure needed it.

    Reply
  2. CMAJ

    Post author

    Thank you Kip. Was my pleasure. And thanks for your interesting perspective cgosling. (Émilie Lacharité)

    Reply
  3. Carl Clingman

    Mike King was the illustrator who did all the work on the Carlson twins surgery illustrations. Somehow Bob Morreale’s name keeps getting included when it really shouldn’t.

    Reply
  4. FYI

    Although a large number of people were involved in the surgical planning with Dr. Moir, Michael King should be credited as the illustrator here. He created all the drawings used.

    Reply
  5. CMAJ

    Post author

    Thank you. I will make that edit. If either of you know the animator involved with the craniosynostosis cases, please let me know. I’d love to credit that person as well. (Émilie Lacharité)

    Reply
  6. Brittany O.

    Hello I’m in high school and i am very interested in pursuing a masters in medical illustration. However, when i look to see what would be a good prerequisite to taking on that as a masters, i have read to concentrate on art and biology, which i find to be very broad. Are there specific science majors that i should pursue but still have a good job standing on its own?

    Reply
    1. Kip

      Hi Brittany, I am a practicing medical illustrator and an Adjunct Assistant Professor at the Graduate Program in Medical Illustration at Georgia Regents University. I would recommend that you visit http://www.ami.org and review the accredited programs. You are exactly correct to take courses on drawing and painting and biology. Each accredited program will tell you their prerequisites for academics and your application portfolio. You have chosen a very rewarding career. Best of luck.

      Reply
    2. CMAJ

      Post author

      Hi Brittany. I think it’s wonderful you’re pursuing a career in medical illustration. Like Kip mentioned, the Association of Medical Illustrator’s website has many resources. In terms of specific majors, I’m not too aware of which are best for jobs other than medical illustration. Generally, medical illustrators have some sort of human biology major, but I know many who have a fine arts degree with a minor in science. The options can be overwhelming, but a pretty safe bet is to stick to courses/majors for which you have a true interest and passion. Hopefully, the rest will follow. Best of luck! Feel free to ask any other questions. (Émilie Lacharité)

      Reply

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