guest post by François I. Luks
It is pretty obvious that medical illustration has its roots in classic art.
The early medical illustrators were artists and painters first. Jan Steven Van Calcar and other draftsmen’s anatomic plates for Vesalius’s De Humani Corporis Fabrica, Gerard de Lairesse’s for Professor Bidloo, Jan Wandelaar for Bernhard Albinus (Figure 1), and Jan van Rymsdyk’s for the Hunter brothers are all masterpieces that are as beautiful to look at as they are scientifically accurate.
As medical knowledge evolved, however, science became less contemplative (anatomy) and more procedural. Advances in physiology, pharmacology, embryology, and biochemistry paved the way for evidence-based treatments. With the advent of anesthesia, aseptic techniques, and a refined understanding of human pathophysiology, increasingly daring and complex surgical interventions could be performed. This moved the realm of medicine and medical illustration from static and observational to dynamic and interventional. Where classic art had been a perfect learning ground for the field of medical illustration, the modern era of medicine required an additional source of inspiration for illustrators.
Enter the ninth art. The term originated in the 1960s in France, where it is still used to describe the world of comics and graphic novels (the six classical arts, according to Hegel’s Aesthetics, were architecture, sculpture, painting, literature, music, and dance; cinema became known as the seventh art form, and television and media in general are the eighth).
Comics (manga in Japan, or BD, short for bandes dessinées, in the French-speaking world) combine literary narratives with visual arts, but they introduce a new element: dynamic annotations. The light bulb, to denote inspiration, originated in the comics, and is universally understood as a sudden event that turns fumbling in obscurity into instant clarity. It not only illustrates the bright idea, but the immediacy of the feeling as well. What separates comics from static art is the conveyance of motion, action, and dynamism. A fast-moving car on a dirt road leaves behind a cloud of dust. By extension, fast-running comics characters are depicted with a small cloud behind them, usually accompanied with a swoosh or motion lines (annotations that also find their roots in animated cartoons, themselves inspired by early cinema). To show directional motion, the comic book artist may even add repeated partial outlines of where the character just was in an attempt to show an entire moving sequence in one image.
Emotions can be expressed with radial lines, sweat droplets, smoke, or thunderclouds—all shortcuts to evoke an action or a mood in one illustration. While medical illustrations don’t typically depict anger or anxiety, they may need to suggest motion, dynamism, a logical progression, or an acute event. Good medical illustrations also collapse time, showing successive actions or events in a single image. To enhance the value of such an image, the use of comics-inspired annotations is frequent, and, thanks to our collective cultural baggage, we understand these archetypal symbols.
Creating shortcuts to simplify a more complex concept depends on the intended audience. It draws from our collective consciousness, including our cultural baggage. Figure 2 shows several seemingly random expressions, ranging from a wry smile to a stern gaze. If given the information that these represent classic paintings, viewers might recognize these as the iconic expressions they are associated with: Mona Lisa’s enigmatic smile, Edvard Munch’s The Scream, and Grant Wood’s American Gothic, an austere father-and-daughter portrait (Fig. 3). Da Vinci’s and Munch’s masterpieces are almost universally recognizable. While American Gothic is a national treasure, however, that painting may be less well known on the other side of the Atlantic. The Aha! moment one has when instantly recognizing the context around an icon can easily become a Huh? reaction for the wrong audience.
About the Guest Author: François I. Luks is professor of surgery at the Alpert Medical School of Brown University and pediatric surgeon-in-chief at Hasbro Children’s Hospital. As a medical student, he drew a daily comic strip for several newspapers and later started to illustrate some of his own research publications, then those of colleagues. To learn more about Dr. Luks, follow him on Twitter, @FrancoisLuks.
About the Book: MedSpeak Illuminated: The Art and Practice of Medical Illustration begins with a history of the field, including some of its historical controversies and darker aspects, such as the relative lack of diversity in medical illustrations. Currently, Luks asserts, an increased recognition that medical illustration has long been complicit in promoting a single view of health and disease has begun to result in changes to practice and content. Like the illuminated manuscripts of old, MedSpeak Illuminated provides visual components for better and deeper understanding, an invaluable resource for students, practitioners, and all those committed to becoming better communicators and more caring professionals. You can purchase MedSpeak Illuminated here.
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