Where medical masterpieces are made

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As an oil painter in college, Elizabeth Cook expected to pursue the life of the typical aspiring American artist: get an advanced degree, move to a big city, embark on a future of creative struggle.

Then she attended an exclusive arts workshop in New York.


"Here I was, right in the center of the contemporary art world, and I saw that in addition to talent, you had to have a big ego and be comfortable selling yourself," says Cook, a Louisiana native and a 2008 summa cum laude graduate of Louisiana State University. "I needed something more down to earth and predictable."

So she reached out to another part of herself.


Cook, who happened to have excelled in biology in high school, recalled something about a tiny master's program in the Johns Hopkins University School of Medicine. Known as the Department of Art as Applied to Medicine, it has been training students in the esoteric art of medical illustration since the early 20th century.

"I sat down to research it online, and the place emanated this wonderful sense of tradition," she says. "I saw I could merge my love of art with my passion for science." She's now one of 12 students enrolled in a department that has been defining the field since 1911.

Cook will be among those on hand Wednesday as the program celebrates its 100th birthday. Doctors, scholars and friends from around the world will attend a daylong symposium on campus, hearing talks on developments in the field, perusing an exhibit of works by the program's 432 graduates, even sampling a custom beer known as "Brodel Brew."

The department's founder and spiritual touchstone, Max Brodel, a German-born artist and polymath, helped concoct the recipe during Prohibition.

"He was the father of medical illustration," says Gary Lees, the department's fourth chairman. "He also said he had fun every day of his life."

As the centennial looms, that as much as anything is the tradition to which Cook and her colleagues belong. She's honored to be part of history — but happier still just to have found a place that values both the artistic and the scientific in life. "I'm having the time of my life," she says.

A new field

If you've seen a placard showing the effects of smoking on the lungs, a diagram of the intestines or a 3-D representation of a protein string, you've seen the work of medical illustrators.


Their media have changed with the centuries, but their main goal has not: making visible what skin, blood, and layers of tissue conceal.

"Brodel taught that the medical illustrator should be like the poet or the journalist," says Lees, who became director in 1983. "A drawing can be lavish and beautiful, but if it's a good medical illustration, it also teaches."

Artists have been trying to depict human anatomy and the pathways of disease since the third century B.C. Renaissance artists like Leonardo da Vinci, who observed dissections, drew muscle and bone more accurately. During the 1500s, the anatomist Andreas Vesalius hired artists to create an atlas of the body.

But the ancient Greeks never saw internal organs, da Vinci's drawings weren't published for 300 years and Vesalius' artists had no science background. It wasn't until the 1890s that anyone even tried to make medical illustration a teaching tool. It happened in Baltimore.

Max Brodel (pronounced "BROY-del") came by his ideas early. When he was a boy, his parents encouraged him to study piano, and he excelled at it. But he gained fame at a Leipzig art school for charcoal and watercolor works that showed his subjects with striking exactitude.

"Every student, in addition to acquiring the skills that established him as a creator of 'fine arts,' also [had to] learn a utilitarian technique that would [always] enable him … to earn a living," wrote authors Ranice W. Crosby and John Cody in their 1991 book, "Max Brodel: The Man Who Put Art Into Medicine."


In 1888, Brodel, then 18, was doing drawings for a physiologist when his art came to the attention of Franklin Paine Mall, an anatomist visiting Germany from Hopkins. Mall sold Brodel on the idea of moving to Baltimore to work at the Hopkins medical school, set to open in 1893. By 1894, he was illustrating the research of its top doctors.

He summoned his talents to create a new field. Brodel learned so much anatomy the physicians let him write chapters in their textbooks. He pioneered art methods, creating transparent layers to reveal structures beneath; drawing "exploded" views of organs and offering cross-sectional and lengthwise perspectives.

"Brodel saw the artist not as a hired hand but as a collaborator with physicians, an equal partner," says Jennifer Fairman, a 1996 graduate who is now an assistant professor in the program.

He also took a scalpel to the past.

"In looking over our medical literature, one cannot help being disgusted by the inadequate character of the illustrations," Brodel told an American Medical Association meeting in 1907. "I do not refer merely to artistic inefficiency, which is evident, but also to the scientific inefficiency. The remedy is simple enough, but its application is more difficult: 1. Teach the artist more medicine; 2. Teach the scientist more art."

Four years later, the philanthropist Henry Walters endowed the Department of Art as Applied to Medicine, creating the first academic program of its kind. Its first director based his curriculum on the two "remedies." Brodel ran the place for 29 years.


'Brodel DNA'

Lees, an award-winning surgical illustrator in his own right, is an upbeat, talkative man, as happy to be the master's inheritor as he is to laud the work of his students. But two weeks before the centennial, it's tough to get on his calendar.

He's hard at work slating 24 guest lecturers, making sure the exhibit's 400 works are in order, finalizing conference brochures (illustrated by his eight full-time faculty member) and even showing off commemorative mugs for the centennial. (They sport a Brodel etching.)

It's quiet in the department one afternoon until Lees, 67, strides in, the second-year students in tow. He has just taken them to lunch.

"Yep, we can fit the whole department in one car," he says with a laugh, and the six — one man and five women, all between 22 and 34 — offer "hellos" on their way to the drawing studio.

Finally, Lees has some time. He walks past two computer rooms, some framed Brodel pieces on the hallway walls, even a lifelike facsimile of a skeleton ("No Disarticulation," a sign reads). And as you enter what might be called the department's inner sanctum — a room containing a film screen and a massive Brodel archive — it's hard to believe him when he says the conference has created an exaggerated idea of the founder's impact.


It's visible everywhere, including on Lees.

A native Texan, he majored in zoology during the 1960s but had always been a sketcher and cartoonist. One professor, noting what beautiful images Lees drew of shapes he saw under a microscope, pulled him aside, gave him a brochure on medical illustration and urged him to consider the field.

Nearly every medical illustrator has a rare condition of mind: an innate love for both the right-brained world of art and the left-brained universe of science. Most say it was a relief to learn there's a field that draws on both.

It was Lees' "Eureka!" moment. He took art courses, applied to several programs and was accepted at theUniversity of Michigan.

That's where he first "met" Brodel. Lees' mentor, a man named Gerald Hodge, had studied at Hopkins under Ranice Crosby. (She was also program director for 40 years.) Crosby learned her trade from Brodel. "I do have the Brodel DNA," Lees concedes. It's not a rare condition in a world in which the German emigre started the first school — and his proteges started and ran the next half-dozen. (There are six in North America today.)

He hauls out a few Brodel works and admires the keenstrokes. He tells of Brodel's many interests: his passion for roses, his vacations with Hopkins' top doctors, even his close friendship with the legendary critic and newspapermanH.L. Mencken.


Brodel, whose piano-playing talent was nearly of concert quality, was a member of Mencken's fabled Saturday Night Club, a group of friends who assembled to play music and drink beer. The writer and illustrator often played duets.

"[Max] and I have been hammering the bones together, man & boy, for 28 years," Mencken wrote in a 1932 letter. "He plays the primo, I play the bass, and the poor pyano leaps and hollers in the middle."

"Brodel was an active person," Lees says.

He sets up a projector to show the work of recent graduates. One, Lydia Gregg, used 2-D and 3-D Flash animation to show a semipermeable stent inside a swollen blood vessel.

The moving image is worthy of a blockbuster film, as liquid rushes through the filter, reducing swelling. "That's teaching," Lees says.

A 2007 graduate, David Cheney, worked with Hopkins anatomist Dave Weishampel, a dinosaur specialist, to probe the scientist's theory that hadrosaurids, or duck-billed dinosaurs, chewed with jaws that worked from above and below.


Cheney acquired, photographed and scanned 23 hadrosaurid skull bones, creating an animation in which the bones leap into place, the "skull" rotates and the pieces demonstrate exactly how the strange chewing motion probably took place.

"People ask how we differ today from what Brodel did," Lees says. "We don't. Our tools have changed, sure, but we're still educating with pictures."

An elite group

Only six students are around this summer — six more will enter in August — and as they sit at computer screens in a lab one day, they're so relaxed it's hard to believe they're people who survived a grueling admissions process only last year (the program rejects 90 percent of applicants), routinely pull 80-hour weeks and lay out a yearly tuition of $42,600.

Maybe it's because almost all graduates join the ranks of the 2,000 or so people employed in the field worldwide. Recent alumni work at the Mayo Clinic, the New England Journal of Medicine and the National Institutes of Health, generally earning $60,000 a year to start.

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Cook squints as she touches up an illustration of birds. Eo Trueblood, 34, has taken dozens of photos of a boa constrictor and uses Photoshop to weave them into a single image and add color. Elyssa Siegel, 22, of Reisterstown uses a computer mouse to manipulate a 3-D image of a myosin molecule, its purple and green portions delineating its major parts.


"The learning curve on 3-D has been very, very steep," she says.

They hail from as far afield as China, but as the conversation flows, it's clear the students have a few things in common. They like the school's emphasis on the basics, from the anatomy classes they must take alongside Hopkins' med students to the rudiments of pen and ink. They love the "storytelling" element of the field.

"A good illustration relates specific information by highlighting some elements and downplaying others," Cook says. "Professors are always standing over us, asking, 'Why did you include that?' We say, 'Because it was there.' 'Take it out. It's not part of the story.' Eventually you see what they mean."

And finally, they share something with the legend who looms over Wednesday's celebration: Like Max Brodel, none would be happy with a one-dimensional life.

"In medical illustration, art and science couldn't be more integral to each other," Cook says. "If you don't have passion for both, you won't be effective. That's what drew me to this field."