A diagnosis isn’t always an easy thing to get, especially when it’s a difficult one. You can be bombarded with information, and sometimes this can be difficult to process, especially when you can’t visualize what the problem is. That’s where illustrations become essential to telling a story. The adage of “A picture paints a thousand words” becomes even more vital in helping patients understand their diagnosis and the procedure around them.
Medical Illustrations As A Common Ground
Medical illustrations make a diagnosis accessible. We all process information differently. With patients with a range of education levels and abilities, they set a common ground for medical professionals and the public to understand their situation.
Some of the best-known illustrations of TTTS, TAPS, and SIUGR are by Amanda Gautier of Gautier Scientific Illustration. Her series, “Learning to Share,” was part of her thesis.
The images are recognized and reproduced worldwide to help patients and medical professionals understand and explain monochorionic twins’ complications.
We were fortunate recently to speak with Amanda and talk about her illustrations and her passion for breaking down information barriers.
Thank you for your time, Amanda. Tell us about yourself and your passion for drawing, and in particular medical illustrations?
I have always loved drawing and was also interested in medical science and anatomy. I found a way to combine those passions in the Master of Scientific Illustration at the ABKM Maastricht. From the moment I found out this was a profession, I knew I had found my dream job!
What inspired you to draw the complications of monochorionic twins and make it the topic of your thesis? It’s a specialized and small field, so what were your motivations?
For my thesis, I wanted to illustrate intrauterine surgery – surgery inside the pregnant uterus. LUMC is the national referral center for fetal therapy in the Netherlands and world-leaders in TAPS research. My supervisors suggested a project including TAPS and TTTS laser surgery.
It was inspiring to see the specialists work up close, and I was even present at laser surgery. It made for a humbling experience seeing the tiniest hands and feet I have ever seen flash by on a screen while the experts worked on the placenta, all the while making sure mom and dad were reassured and informed.
What do you think the role of medical illustrations are?
There is a difference between the information a specialist communicates to a patient and what the patient understands. Medical illustrations can enhance communication between patients and doctors and help patients with different educational backgrounds understand their diagnoses and treatment.
When receiving a diagnosis, emotions come into play, and the patient might forget to ask questions right on the spot. Medical illustrations can help process information at a later time.
You spoke in your thesis about a need to draw differently for patients and medical professionals – can you tell us a little more about this?
Medical illustrations can be for patients as well as professionals. Both audiences have different needs in pictures. Drawing for professionals is more about the ‘how’ (how do I hold my instrument/hands, how do I make sure I enter the incision site from the right angle). Drawing for patients is more about the ‘what’ (What will happen to my body?).
When explaining a new surgery technique to a professional by using medical illustrations, the audience will be interested in the surgical instrument, the surgeon’s actions, and his hand positions.
When explaining laser surgery to an expectant mother of sick twins, she will want to know what will happen to her children and body. This might entail showing a before and after the surgery instead of the instrument in action. I will omit the actual use of tools if at all possible.
What are some considerations you have to make when illustrating?
First, I take into account how I want to tell the story. The arrangement of picture elements may differ based on how familiar the audience is with the subject.
With illustrations for patients, I will start with an overview of where we are in the body before ‘zooming in’ on the area of interest. This is so the patient is aware of what we are looking at.
Professionals don’t need as many orienting elements. Illustrations for professionals can include anatomic structures. In a similar picture for a patient, those structures might be omitted because they are unnecessary. They’re distracting from the story, or even unsettling.
The function of color is also essential. Color can be used in different ways, depending on the audience. When creating illustrations for patients, I try to make sure the colors are reassuring and softer. In images for professionals, the colors are usually more practical. There is a convention that red is used for oxygenated blood, blue for deoxygenated blood, yellow for nerves.
When using those colors, structures are understood by the audience as intended immediately. Color is always used with a specific goal.
Learning to Share is a beautiful title for your thesis and very relevant to parents of monochorionic twins. Was there anything you learned during the thesis that was fascinating to you about twins?
I have learned so much about twins. Before the thesis, I had only heard about identical and fraternal twins. Meanwhile, I have learned about the different types of identical twins and how the cell division’s timing is crucial to how much of the placenta and sac they share. I never knew they could share a circulatory system and the problems that it can cause. My favorite part of being a medical illustrator is that I learn something with every new subject.
Creating An Equal Ground
Medical illustrations are vital when it comes to communicating complications and a diagnosis to patients. By breaking down the jargon walls, and visual representations, patients can understand their situation, treatment options, and outcomes.
The medical illustrator’s role is to tell a story to different audiences, and they decide how to say the information so that everyone understands. It is a job that requires much skill. You need to adapt knowledge, break it down across various audiences, and, most importantly, convey an important message.
Embracing different approaches to explaining diagnoses to patients means that they can leave an appointment with understanding. Through illustrations, it also means that literacy and education barriers can be broken down. This means patients can advocate for their pregnancy with the best information possible.
Join the conversation in our Facebook group, or visit our advocacy website . We’re breaking down the jargon barriers and creating a space where doctors, researchers, and patients can interact on one level.
The TAPS Support Foundation is grateful to both Gautier Scientific Illustrations and the LUMC Fetal Therapy team for their generosity in letting us use the images for this article. The images remain the property of the artist and the LUMC Fetal Therapy team and may not be replicated, or reproduced without their consent. Images used with permission.