When Roy Schneider received his medical illustration degree more than 30 years ago, he routinely transferred his knowledge of the minutiae surrounding the human body to foam board with pen and ink.
Today, that professional role has stretched into another dimension with the rapid growth of the computer age, and Mr. Schneider joins others in the field who are now reaching for an illustration tool on the computer, or for 3-D glasses needed for a virtual tour inside the human body.
“Airbrushing, watercolor, pen and ink have all been replaced with the pixel,” said Mr. Schneider, manager of medical illustration and virtual immersive reality for the University of Toledo and its medical center. “Are there compromises? Yes. Are there benefits? Yes. But pixels don’t smell and the pixel colors don’t blend like those tubes of paint we were so accustomed to.”
While they still provide illustrations for publications, these days medical illustrators are visual problem solvers who often produce illustrations for animations, videos, and phone apps; images that leap off the pages of the medical journal and into a 3-dimensional environment.
Pencil and ink have been replaced with Photoshop and other navigation tools used to layer computerized drawings over CT scans.
“Mistakes are not devastating, like years ago, when the ink smeared or the airbrush splattered. Now when I make a mistake, I simply hit a button to undo,” said Mark Schornak, president of the Association of Medical Illustrators and a medical illustrator at the Barrow Neurological Institute at St. Joseph’s Hospital in Phoenix. “You save your work. You build the art in layers. So when the doctor comes in when it is almost finished and says ‘move the instrument a little that way or make the aneurysm bigger,’ you can respond immediately.”
On the UT Health Science Campus sits one of the latest illustrative advances in medical training: the Virtual Immersive Reality Center. Computer-aided design walls allow students to interact with a 3-D rendering of the inner workings of a revolving human body. Move into the center’s I-Space Computer Aided Virtual 3-D Stereo Environment, or CAVE, and walk up through the nose to view the spinal cord and nerves. Squat down and look up to research the base of the brain and pituitary gland.
The technology advancements are not without cost. The Interprofessional Immersive Simulation Center, which also includes an Anatomy and Surgical Skills Center and an Advanced Clinical Simulation Center, cost the university more than $30 million when it opened in April, 2014.
The real-world experience in the simulation center sends students to the dissection lab better prepared, Mr. Schneider said.
“The beauty of this is [that] the students get an appreciation of the volumetric rendering of a CT [scan] and the spatial relationships that you see, not just the structure and organs themselves, but the whole body,” he said as he showed a revolving body that emphasized rib and lung injuries. “It’s a unique way to get inside the body, cruise around inside it, walk around it.”
When UTMC third-year medical resident Mike Abrahams steps into the center’s I-Space, the simulated emergency is evident. A three-car collision has occurred, and some of the individuals involved have been
ejected. He “walks” toward each victim to assess extent of injuries and whether they need immediate attention, while watching for downed power lines and other obstacles.
When he first came to UT to do his residency as an emergency room physician, that scenario was presented two-dimensionally.
“When I started out, the way we did this type of stuff is ... it was a PowerPoint where [instructors] would throw up a slide and say, ‘OK this is what you do, and there are bullet points that come up, OK make sure scene is safe, b) make sure this and that.’ This is totally different,” Dr. Abrahams said. “It’s easy to circle the right answer, it’s not always easy to think of the right answer. So when you are put in these situations, you’re not circling the right answer you’re actually thinking of the right answer.”
The medical information cards that assist Dr. Abrahams and others with information about vitals, heart rate, and the person’s condition, and some of the realistic images in the triage scenario are the work of Tonya Floyd-Bradstock, a medical illustrator in Mr. Schneider’s department. When she was in the undergraduate fine arts program at Bowling Green State University in the late 1990s, the movement toward a digitized profession was under way.
While she learned the basics of line and perspective as an intern under Mr. Schneider’s wing at the former Medical College of Ohio, Ms. Floyd-Bradstockher’s computer was upgraded mid-degree and Photoshop and Illustrator were routinely used.
“We kind of bridge the gap between computer people and content experts. We really get to mold where these programs are going and enhance the profession. It’s exciting to see where we can go with it,” she said.
Medical illustrators combine art and science education to achieve a bachelor’s degree and then a two-year master’s degree: anatomy, physiology, and pathology are combined with figure drawing, color theory, and specialized art course such as surgical illustration.
Mr. Schneider and Ms.Floyd-Bradstock got their medical illustration master degrees from the University of Michigan, which has since ended its accredited medical illustration program. Only three such programs exist in the United States today, according to the Association of Medical Illustrators: Georgia Regents University/Augusta University, the University of Illinois at Chicago, and John Hopkins University School of Medicine.
Medical illustration dates back to the 4th Century B.C., when individuals drew anatomical illustrations on papyrus. The creation of the first medical school of illustration by Max Brodel, a 19th Century German who studied at John Hopkins, paved the way for other schools and the eventual formation of the Association of Medical Illustrators in 1945.
The profession continues to grow from Mr. Brodel’s days, Mr. Schornak said. Textbooks are accompanied by animated videos or computer programs with robotic interfacing that allow a trainee to feel tissue and bone as he pushes a hypodermic needle through a knee. Simulators teach surgical techniques. Phone apps allow students to self-test themselves.
Nonetheless, medical illustrators agree traditional technique still applies.
“[Medical illustration] is still a visual communications tool for medicine. We are still trying to communicate complicated ideas and explain something that is hard to explain in words. Now we just have a lot more opportunity with 3D modeling and 3D animation,” Mr. Schornak said.
Contact Roberta Gedert at: rgedert@theblade.com or 419-724-6075 or on Twitter @RoGedert.
First Published April 18, 2016, 4:00 a.m.
