The heart is, “an arrangement so unusual and perplexing,
that it has long been considered as forming a kind of Gordian knot in Anatomy.
Of the complexity of the arrangement I need not speak further than to say that Vesalius, Albinus, Haller and De Blainville,
all confessed their inability to unravel it”.
–James Bell Pettigrew, 1834-1908
If anyone suggests to you that science, particularly biological science and medicine, is not beautiful and not much more than “a dissection”, as someone once said to me, I could offer you a place to begin… a place of great beauty to point to.
It is one of the fascinating details of evolutionary embryology that I loved learning as a student: the vertebrate heart evolved from a single simple tube into the complex structure we know as our heart. Here is the heart of a human embryo before two weeks:
Here is great old animation depicting the human heart formation:
In fact, while embryologists understood this folding pattern by observing cardiac development, it wasn’t until 2006 that the anatomist Torrent Guasp, using a special technique, dissected the human heart for the first time in history. In this skillful dissection he uncovered the original embryonic tube structure. Here is a video explaining Torrent Guasp’s dissection:
“When I looked at the heart for the first time I saw a circumferential basal loop. And then I saw a descending limb and an ascending limb. And they curl around each other at a helix and a vortex, except for the ventricle. And the angles at which they go is about 60 degrees. 60 degrees down and 60 degrees going up, and they cross each other in that way. For years people had wondered why this happened. I realized this is really a spiral. And I began to think about spirals. And I began to understand that spirals are almost the master plan of nature in terms of structure and in terms of rhythm.… if you pick the middle of the spiral up you form a helix. And of course the heart is a helix.”
-Dr. Gerald Buckberg, M.D.
So, for one of my own favorite illustration projects, I began my work by researching this folding pattern, and drawing its reach into the heart. As you can see, the folding works a little bit like a knot, and it is also a two-ended spiral.
I made a sample out of clay and practiced the folding pattern.
And here are my illustrations to reveal the tubular unfolding pattern of the human heart:
As you can see in these illustrations, the adult human heart in its evolved form is a flattened tube, and behaves like a rope as the muscles wrap and squeeze blood. But it is a very complex knot, the dissection of which was not even achieved until the past few years, with Torrent Guasp. How remarkable that a structure so complex can be reduced, backwards, so that its simpler origin is apparent.
This month Med Monthly welcomes Laura Maaske on board as a staff illustrator, writer and journalist. She will be supplying an article or illustration each month dealing with ground breaking health care advances and state-of-the-art medical images. She has been a regular contributor, with several articles during the past year featured in our Research & Technology section.
With a Master’s of Science degree in Biomedical Visualization from the University of Toronto, she is bound to amaze you with wildly colorful, graphically outrageous images and an interesting insight into her world. Simply combine anatomy, physiology, pathology, embryology, histology, with design, airbrush, carbon dust, pen and ink and there you’ll have it; the beauty and wonder found in the human body as seen and expressed by a master illustrator. Collaborating with scientists, physicians, and other specialists, medical illustrators serve as visual translators of complex technical information to support education, medical and bio-scientific research, patient care and education, public relations and marketing objectives.
Laura did her masters research on interactivity in computer design and experimenting with the small world being offered by a computer interface. Laura explains, “It was like science itself, in a nutshell. I wanted to be creating small worlds where you were able to learn how things worked.”
If you review Laura’s website, you’ll notice she states that all of her work is done by hand. Once again, having been trained in traditional art, she always begins with a hand-sketch. “Bringing the work (sketch) to the computer is a useful step in the process, but I do this only when I feel I have captured the essential movements and curves on paper that are to be the underlying focus in the final piece.” Every project that Laura creates is custom done. In the inception of each one she questions, “What does this individual piece have to say to its audience?” Only then can she truly begin to develop the perfect concept for her final piece.
What is the most difficult question to ask such a complex artist? What project are you the most proud of and why? Laura replies, “As an artist, I am in search of a balance between the chaos and rich excess of information being offered in the surgical scene and simple educational objectives about that particular procedure. There is a particular series of surgical illustrations which gave me insight about this balance. It had been a goal of mine to render the surgical scene in a way as if the surgeon were operating in a clean field. It was my job to clear away what a photograph could not. But it occurred to me as I was beginning to draw the series that perhaps I was avoiding something beautiful about the nature of surgery, to avoid the dissolution. During a surgical procedure, the tissues become a little swollen, and there is some bleeding, and this is all understood as a way of adapting the body for a healthier state of being when the surgical procedure is done. But it seems like a contradiction: destruction first before healing. We open the body, aware of this small loss, in favor of a greater gain. So I decided to render this dissolution in my surgical series. The results worked in a way that seemed very natural to me, compared to what my cleaner renderings had been as in previous work. This lesson made this project very special.”
Laura shares a whimsical illustration of her creative process in the making of a medical illustration.
We welcome Laura and her creative touch to our evolving group of talented professionals here at Med Monthly magazine.
View the full article at http://medmonthly.com/research-technology/med-monthly-welcomes-laura-maaske-as-a-staff-illustrator-writer-and-journalist/#!
What comes to mind when you think of a medical and scientific illustrator? Is it a kind of art you admire? How do you respond to highly detailed drawings? Do the fleshy human interiors make you squeamish, which is a remark I have sometimes received from clients regarding medical images in general? Does the precision impress you? Does the stiffness offer you stillness or rigidity, something to explore? Do you love the great masters of the field: Leonardo DaVinci, Andreas Vesalius,Max Brödel, Frank H. Netter, John James Audubon?
As a student medical illustrator, I knew what I wanted to learn. I wanted to wrap my mind around the science and the drawing skills I would require in the future. I already had an undergraduate degree in zoology, and our courses in the Division of Biomedical Communications were to be shared with the medical students at the University of Toronto, so science was heavily on my mind. There were levels of basic knowledge I needed to learn and those were challenging enough. I saw the scientific method as the most reliable process for truth-seeking. It seemed to me, if I could grasp what was being taught, that the classes I enrolled in formed rational containers to hold all the knowledge I would need in my work: anatomy, physiology, pathology, embryology, histology, design, airbrush, carbon dust, pen and ink, wash, to name a few. I still adore them all.
What a remarkable world we live in that an idea like the scientific method with its meticulous observational approach and the respect for repeatable results that it nourishes, have produced such a vast body of insights. And also, how remarkable that the notion of an artistic apprenticeship and the skills it entails have created a line of hands reaching back in history: generations of artists still passing the skills down in a highly oral tradition. We live in a world with a high degree of specialization in our work, so the idea of mastering that breadth is simply not possible. But what a joy I felt to be learning in a place with others who wanted to grasp, to whatever degree possible, both science and art.
I didn’t realize then, because I had not yet discovered the nature of my personal search, that while I admired the greats in medical illustration and studied their hand-strokes for a glimpse of the genius they contained, that there might be something deeper to be reaching for in the execution of that fluid line than the enticing surface of the lovely stroked paper itself. Looking at the masters, I didn’t see what I would later identify in them as the source of inspiration. It’s what gives any artist the energy of the search: the pull from within, the questions one might be asking, or the personal exploration. That expression might begin in an awkward way, with a sense of the gentle tug that begins from one’s heart, moves to the head, and then emerges out of the fingertip. This is what the Chinese calligraphy masters suggested. It is the discovery of unity, beauty, and self. There must be other ways that artists have found. But this is the way it happened for me.
I was discovering a second wellspring of knowledge in addition to science. I was beginning to respect another empirical source: my instincts. Looking to the great artists and poets I began to see a shared language in the exploration, and a gesture pointing to some kind of truth beyond rational grasping. Poetry and art are themselves a source of truth and this can be discovered and revealed with the same attentiveness and dedication and need for honest acceptance of results that a scientist lends to the process of discovery.
Finding freedom of this kind may be inborn to some artists, but has taken me years to unveil. Even as a student, or especially then, I recognized that my arm was tight and my line did not flow luxuriously. I appealed to Professor Stephen Gilbert, a master with the pen. He suggested I draw a hundred circles a day, in the morning before class. I did this exercise, but I found myself becoming more rigid and feeling as if I had less control over my hand than ever. Even a ritual like this was not reaching me. Professor Gilbert then suggested that I begin to explore a looser style, which seemed at first a contradiction to the precision I was looking for. He was right. In my personal drawings, I had a looser style. But I found, over time, there began to be a connection between the loose sketchwork I loved to prepare in my personal work, and the tighter style required for my profession.
Recently, a fellow artist asked me how my own questions might come out in an everyday practice of illustration. I guess it begins with the first questions we ask as we draw: wondering about the patterning of life. Why does the branching of the tree look so much like the arterial branching patterns? What does light mean as it passes through a leaf wall and how should it look as it is passing through a cell membrane? What is light, anyway, that it behaves in such a different way from other materials I am drawing? I take these questions to my camera, which has offered an ongoing exploration and source of new insight to my depiction of the inner forms. Questions about beauty are newer to me. I wonder what makes the shape of a line beautiful. I practice making curves on paper. I wonder about these curves when I draw any form or any shape, and I ask instinctive questions about whether a line I’ve just drawn offers that beauty.
Other questions begin in a more practical place, but make me wonder about greater things. What makes a medical illustration impactful? Is there any such thing as beauty in the depiction of a disease process? How can the experience of looking at a medical illustration be made to be meaningful to a person who needs help making a health decision? How does a person turn to the outside world to help make decisions about health and medical choices? How can an illustration hold this kind of inspiration? What is the nature of the relationship of a person to the world and its ability to influence actions? As a student, I preferred quantitative research which offered the most shallow results from the greatest number of people. Now, in conducting small qualitative surveys for my illustrations and work, I find myself simply preferring this approach. It allows me to rely on my instincts as an artist, and to ask deeper questions. I’m not so concerned about universality.
In that reach from myself, and despite this technological age, there is hand-work. I ask the question that all artists ask, and maybe every person asks: can I make what’s deepest in me real in the real world?
I was five years old and I slid to the front seat of the car, looking up at the back-lit letters designating the drugstore into which my mom had stepped. I had spent a lot of time looking at letters: such beautiful things! I asked my dad, “Why do those letters up there look so happy: happy more than any letters anywhere? I’m trying to think how I could make them even happier, but they are perfect.” My dad looked from his Popular Mechanics before answering, “Because they want you to feel like going in. They want you to buy something.” I thought about all the happiest letters I knew: all names on storefronts and advertisements in the paper. I wondered if these letters would be devastated if no one bought something anymore. I felt a crushing, sympathetic sadness for the letters and their unfulfilled desire. At that age, I hid certain food labels –the logos themselves– from the trash because I thought they would be sad if I threw them in the garbage. I asked my dad, “Are there any happy letters that know how to be happy even if you don’t buy something from them?” I remember how my dad laughed ruefully to himself as he thought about that and answered, “No”.
That emotion my dad felt there was so resonating I began to almost hate letters then. Even last year when my five-year-old daughter, Autumn was learning words she said, “Mommy, I see a word: Speedway”. I had not mentioned brand names with my children (I used my own names instead, without really thinking about it, because the real names seemed such a loss of innocence). So for my daughters, reading these brand names was a new discovery. I heard myself responding to my five-year-old that morning, “Be careful now that you can read. Words, especially words on signs, are always trying to make you do what they want you to do.”
David Abram draws attention to the beauty of the letter by revealing its historical power. He seems to find a way to be close to nature without losing his love for letters. But I responded most to his ambivalence: an alphabetic culture has sublimated the love of nature over into the love of letters by looking from the tree down into the book. So, Abram reminds us, there is necessarily a loss of adoration for and involvement in the natural world as a consequence of the abstract letter form which, unlike kanji, doesn’t even reference nature.
What I feel now is, that’s not the whole truth. We know ourselves to be humans living in a culturally pluralistic way, with a long-ranging historical perspective. We see how, over time, humans have imbued almost every available item with power. So we can now begin with more awareness to choose for ourselves our own gods, which symbols are the best, and where to place our worship. It’s not the detached worship of an Enlightenment philosopher seeking objective truth, but the real worship of an Ecstatic who is not a slave to objects and who knows the individual’s proper place in the pantheon.
The beauty in the word is something I am only beginning to see again. I now engage almost as if in conversation with letters and words: I relate and interact to the intention there, rather than observe and walk away. And I’m now in the search for Borges’ Aleph: that central holding place for everything in the universe.
Do you recall your first discovery of light when you were a child? What an alluring beauty that intangible phantom presents for babies at a certain age. I remember a great many things from my childhood, but not that discovery. Perhaps I ignored it or it didn’t fascinate me the way it should have. And maybe that’s why it took so many years, until last August, for me to discover light again.
Even the physics we learn in school tells us there’s something very special and elusive about how light works in the real world: it’s a particle and a wave. Nothing else can claim both properties. In art class we learn about the flow of light over objects: core shadow, cast shadow, reflected light, highlight. Light on all materials, whether it is a snowball or a cell, a finger or a blood vessel, can be related to the behavior of light wrapping itself around the basic geometric forms: a sphere, a cube, a cylinder, and a cone.
How lovely it is, that flow of light. An artist’s world begins at that door. But not for me. I didn’t even begin to explore these simple questions about light until I was a graduate student. And then, I was concerned with other great questions: understanding the science and medicine within, mastering composition, exploring the great masters of illustration, mixing color, learning the technology.
What pushed me to an exploration of light at the layers beneath? Spiritual questions, it seems. As a child, my world had been a rational one. Things made sense that way. Then, I discovered the irrational world where emotions and other “out of the ratio” behaviors made sense. My model of a world divided between rationality and irrationality worked well and still does, but there was something shining through, disturbing the sharply defined territories there, and that breach can only be analogized to the behavior of light itself. Perhaps I’ll one day find a good way of explaining this experience. I brought out my camera again to help me ask questions about how light behaves. Taking photos, I was learning deeper answers in the presence of light there: we can do more than reflect light or transmit light, we can ourselves be light.
While a photographer has the magical eye to capture the secrets of light and freeze them for all to learn by, an artist can move one step beyond. Interpret that behavior for me. What does it mean that light passing through a leaf offers the serenity of a stained glass window? How can the golden light reflecting off that icy lake tell me about where to pour my energies in my everyday life? An artist is able to ask these questions. I am finally ready, myself, to begin asking these questions professionally and personally.
What have you learned about light: light as a natural phenomenon; light in art; light as the spiritual metaphor?
“There’ll never be a door. You are inside and the fortress contains the universe and has no other side nor any back nor any outer wall nor secret core. Do not expect the rigor of your path, which stubbornly splits into another one, which stubbornly splits into another one, to have an end. . . .” . .-from Jorge Luis Borges‘ “The Labyrinth”. The Sonnets: In Praise of Darkness. Penguin Classics; 2010
I’ve not made a thorough study of Borges’ Works, nor his Biography. I have, however, enjoyed many of his writings recently.
The door as an abstract form is a transition point: any opening to a new world where rules and scenery change. A door is an opportunity. Perhaps you live in a Seeall world where doors and windows come like a waterfall at warp speed. For me, in a simpler world, I feel lucky to know a true portal when I see one. Borges’ works overflow with references to discrete places that have sharp borders and infinite depth: a rose, the moon, a labyrinth. It seems to me in his world that doors fell on a hopeless, repeating, circular map. I sympathize with a difficult choice, and admire the playfulness and wisdom of asking questions about doors. But I would ask him, if I’d had the chance to speak with him, if he had turned down some door in youth that became his ever-after tormentor. Each true opportunity –each storm– fully engaged, never repeats.
Borges revealed that (depending on the rhythm of one’s own inner map) a critical but unattended-to door may present itself in a thousand different forms. It can do so unrelentingly –think about a time in your life of a recurring dream– because it is the only next step available on one’s path. Or, at the other terrifying extreme, Borges also imagined a world that was door-less. Both extremes –an infinitely repeating circle of doors or no doors— offered worlds with no way out. There must have been some small beauty gained at the place of turning away from a door (like the lovely contemplation of its potential), and perhaps Borges knew about that himself, but I cannot find it in his works. Can you? Borges said, the word that cannot-be-spoken is the most important word in any story. Did he ever write a story or poem about a door that had the capacity to be opened?
Turning to another poet who understood a door, Rumi ingeniously proposed that, in the act of longing itself we are at our closest to touching God. This sentiment seems opposite to Borges’ explorations, and might, itself, have solved Borges’ problem. Without longing, a door has no permission to appear. My first longing, as a toddler, opened my first door. That was my first abstracted concept of “path”, and it arrived as a dream-like visualization of a door filled hallway. It happened upon my mother’s offering of the word, “someday” in answer to my now-forgotten request for some desired activity or object. I asked, “When is someday?” I thought it might be Sunday. I recall the answer was not fully understandable to me. But her explanation, now also lost in time, must have been a wise one to evoke in my mind’s eye a door.
“A clear head at the center changes everything There are no edges to my loving now. You’ve heard it said there’s a window. that opens from one mind to another, but if there’s no wall there’s no need, for fitting the window or the latch” . .-from Rumi, “Sudden Wholeness”, The Book of Love; Transl. Coleman Barks; Harper; 2003
What does the concept of “door” mean to you? Do you agree with Borges that there is no real door?