Medical Illustration Opens up New Frontiers in Human Anatomy

UCLA researchers recently published a study after reopening the curious case of Phineas Gage, probably the most famous victim of head trauma in American History. In 1848 Gage was working on a railway line in rural New England when an explosion shot a four foot long, one-and-a-quarter inch thick iron rod through his left cheek and out the front left top of his head. Though he miraculously survived the accident, his family and friends soon discovered major changes to his personality. Gage would die at 37, only twelve years later, but the celebrity of his remarkable recovery and the published research of his surgeon opened a new chapter in how medical scientists view the relationship of the brain to personality, and also serves as a benchmark for how doctors treat head trauma. The study builds on CT scans of Gage’s skull that were made several years ago. The skull, now too delicate to move, was donated to Harvard by Gage’s family at the behest of his physician, and is on display along with the errant tamping iron. What’s remarkable about the study is that researchers were able to combine the images of the skull with data from more recent research as a means of discovering how exactly the iron rod damaged Gage’s brain. His case stands as an iconic moment in neural psychology, but it also serves a greater purpose today for doctors and psychological professionals dealing with their own patients’ recovery from similar head trauma. Though there is some debate over how permanent these changes were, and the reliability of the record of his recuperation (Gage’s physician was a consummate professional, but the two had limited contact after his recovery), what’s truly remarkable about these digital images is the role that medical illustration has played in reinvigorating this investigation and other ongoing research about the brain, such as the Human Connectome Project.

Medical illustration is an irreplaceable practice that we tend to take for granted in our age of endless graphic interfacing. There was once a time when people were confused about what went on inside their bodies. Some stuff is obvious to anyone. When you’re hungry, your stomach hurts. After you eat, other parts of your body tell you that you need to go to the bathroom. And when you have sex, certain things go on in the body and then later there’s a result—a big result. But other things were no so obvious to our ancestors. That our skin is an organ, that we have an immune system, and that cancer is the creation of the body’s cells in the wrong place, are all things that would have gone over most people’s heads throughout history. People, even doctors, were limited by what they could see with the unaided eye: there were no more cells in the human body than there were moons around Jupiter.

Medical illustration has been in existence almost as long as medical science itself has been put into writing. Ancient physicians in China, the near east, and the Hellenistic world used very basic diagrams of the human form for reference. The Renaissance saw the beginnings of the modern recognition of the potential for medical illustration, especially with the works of Andreas Vesalius, whose illustrations were used for centuries. And that potential, with techniques like diffusion spectrum imaging is doing today what it has been doing for centuries: bringing the mysteries of the human body to light. We can now look at diseases like Alzheimer’s and Asperger’s, even Schizophrenia, in completely new ways that make them less of a mystery and therefore their treatment, and eventual cure, something that everyone can see and begin to understand for themselves.