Why every picture tells a medical story

The ancient adage, “Every picture paints a story,” is a testament to the power of visual imagery in conveying narratives, emotions, and ideas. This phrase encapsulates the ability of images to tell tales without using a single word, to transport viewers to different realities, and to evoke a myriad of emotions. However, the communicative power of stories should not be underestimated either. In fact, stories can paint pictures just as vividly, if not more so, than images. This is particularly true in the field of medicine, where the art of storytelling becomes an essential tool for understanding, diagnosing, and treating patients.

Stories, by their very nature, are evocative. They are filled with characters, settings, conflicts, and resolutions that stimulate the human imagination. Every narrative detail, from the grandest plot developments to the smallest character quirks, contributes to the construction of a mental image. This is how stories paint pictures. They provide the raw materials – the words, phrases, and sentences – from which readers craft their own unique visual interpretations. Every reader becomes an artist, using their imagination as a canvas and the story as their paint.

In the realm of medicine, storytelling takes on a new level of importance. Medical practitioners rely heavily on patient narratives to gain a comprehensive understanding of their patients’ health conditions. These narratives, or medical histories, are essentially stories that patients tell about their bodies and way of thinking. They paint a picture of the patient’s health, lifestyle, and symptoms that can help the physician make an accurate diagnosis.

These stories can be incredibly detailed, providing a chronological account of the patient’s health. They can describe the onset of symptoms, their progression, and any treatments that have been tried. These narratives can also include information about the patient’s lifestyle, such as diet, exercise, and stress levels, which can all play a role in their health. By listening to these stories, physicians can visualize the patient’s health journey, making connections between symptoms and potential causes and forming an overall picture of the patient’s health.

Moreover, storytelling in medicine extends beyond patient narratives. Case reports, clinical studies, and medical literature are all forms of storytelling that paint pictures of diseases, therapies, and medical phenomena. These narratives provide a structured way for medical professionals to share knowledge, learn from each other’s experiences, and build on the collective understanding of medicine.

Painting stories play a crucial role in patient education. Medical professionals often use narratives to explain complex medical conditions and procedures to patients. These stories help to demystify medicine, making it more accessible and understandable to patients. By painting a clear picture of what to expect, stories can alleviate patients’ fears, encourage them to take an active role in their health and foster a stronger patient-doctor relationship.

The illustrations that accompany my online narratives and embellish the front covers of my books remind me that stories are powerful tools that can paint vivid pictures in the minds of their audience. Just as every picture paints a story, every story paints a picture – a picture that can illuminate the intricacies of human health, guide medical decision-making, and ultimately improve patient outcomes. Some of the most iconic images in the history of medicine are emblematic of narratives that are deeply intertwined with the evolution of the field.

Thomas Eakins’ 1875 painting, “The Gross Clinic,” for instance, presents a scene from an operating room at Thomas Jefferson Medical College where Dr. Samuel D. Gross, a prominent American surgeon, performs surgery before medical students. This visual narrative underscores the role of hands-on experience (literally) and observation in medical training and the advent of surgical procedures in disease treatment during the late 19th century. Initially rejected for showing at the 1876 Centennial Exhibition in Philadelphia, “The Gross Clinic” is now recognized as one of the greatest American medical paintings for its uncompromised realism.

In a similar vein, Rembrandt’s “The Anatomy Lesson of Dr. Nicolaes Tulp” portrays physicians observing an anatomy lesson, in this case, Tulp explaining the musculature of the arm. This iconic 1632 painting, regarded as one of Rembrandt’s early masterpieces, emphasizes the significance of anatomical studies in understanding the human body and the importance of continuous learning in medicine.

“The Lady with the Lamp,” painted by Henrietta Rae in 1891, beautifully encapsulates Florence Nightingale’s commitment to improving health care conditions and her revolutionary role in the field of nursing. The painting depicts Florence Nightingale during her time in the Crimean War, holding a lamp while checking on wounded soldiers. The lamp she carries is the most significant element of the painting. It not only provides a source of light in the literal darkness, but it also serves as a metaphorical beacon of hope and comfort for the wounded and sick.

Moving from paintings to photographs, “Photograph 51,” taken by Rosalind Franklin in 1952, reveals the double-helix structure of DNA. This confirms Watson’s and Crick’s earlier hypothesis of the double-stranded nature of DNA and enables them to build the first correct model a year later. Franklin’s X-ray diffraction image is a prequel to the story of the building blocks of life, leading to a deeper understanding of genetic diseases and paving the way for revolutionary treatments, including biologic drugs and gene therapy.

Wilhelm Conrad Röntgen’s first X-ray photograph, taken in 1895, showed the bones of his wife’s hand and marked a new era in diagnostic medicine, enabling physicians to look inside the human body non-invasively. This image narrates a story of medical innovation and its transformative potential in patient care, as Röntgen’s scientific advancement would ultimately benefit a variety of medical fields.

Lastly, the “Blue Marble” photograph, taken by the Apollo 17 crew on December 7, 1972, from a distance of around 18,300 miles from Earth’s surface, tells a story of global health and medicine. By showing our planet in its entirety, it advocates for environmental protection and underscores the interconnectedness of health across nations and the need for global cooperation in addressing health issues. This image has been used to promote global health initiatives and raise awareness about environmental health issues.

Each of these images, in its unique way, narrates the progress of medicine, highlighting key breakthroughs, practices, and perspectives that have shaped the field. They serve as visual reminders of the power of medical innovation and the continuous pursuit of knowledge in improving human health. Paintings remind us that the “art” of medical storytelling involves visualizing its narrative components.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogue and Narrative Medicine: Harnessing the Power of Storytelling through Essays.


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