Author Archives: Claire Shapleigh, Biomedical Visualization

About Claire Shapleigh, Biomedical Visualization

Hi, my name is Claire and I'm in my second year of the Biomedical Visualization MS program at UIC. It's a combination of art and science, and it's pretty fun. So far I've dissected a human body and learned how to draw in 2D using a computer AND my hand, and I'm about to learn how to 3D model. Holler at me if you have any questions about the program!

Biking in Chicago- an Experience Unveiled

I’ve been biking every day I get the chance to class and work, navigating my old-school, silver trek road bike through the streets of Chicago and trying out all the difference routes to both East and West campus. And in doing so, I’ve experienced and seen some strange, crazy and pretty normal things, but things that are very unique to Chicago. I’ve noticed that biking through Chicago takes all 5 of your senses on a roller coaster ride. Here is some of the true grit of riding a bike through Chicago:

The choice between potholes, an opening car door, and a moving vehicle.

Chicago has a vast amount of potholes. And they all seem to congregate directly in the middle of the bike lane. One time I saw a pothole so deep that I couldn’t see the bottom of it! What was down there- a small animal? A shark swimming around in murky waters? It was scary!

The passing smell of chocolate.

There is either one huge chocolate-making factory in Chicago, whose chocolate exhaust wisps around the city with the wind, or there are a lot of small ones scattered throughout the city. I’ve smelled it downtown, I’ve smelled it on the west side, and I’ve smelled it up north. It comes and it goes, and I have no idea where the chocolate is. WHERE IS THE CHOCOLATE? Some day when I have nothing better to do, I’m going to follow my nose and get to the source. Mmmmmm….

The passing smell of trash.

My favorite route to school is directly down Wood St. to campus. There are minimal cars, even during rush hour, due to the fact that Wood runs straight through a warehouse district. The only down side is multiple trash facilities that are hidden in the depths of the district- and I’ve found them. I’ve come to associate the loud beeping of a truck in reverse with the smell of garbage. I try to avoid these trucks but sometimes they find me.

The mixed smell of hot dogs, donuts, chocolate and trash.

Ok I know I’ve expounded up the passing smells of Chicago, but the real experience is the mix of all of them together! I can’t tell if I’m hungry or need a gas mask…

The angry driver.

Classic Chicago drivers: they’re mad all the time. You stop in front of them at a stop sign. They’re mad. You drive 3 miles over the speed limit- they’re mad. You’re turning left in front of them and you take too long to do it- they’re mad. You’re riding a bike- they’re MAD! Well, I have experienced anything too terrible, but it’s the usual accelerate-way-to-fast-around-the-biker scenario. Don’t worry- they usually give you a lot of space–even take up the opposite lane–but they just want you to know that they’re NOT HAPPY about having to pass you.

The occasional overly nice driver.

They’re usually driving a Subaru, and there’s a dog sitting in front, panting out the window. They refuse to go, even when they obviously arrived at the stop sign before you. It’s really nice, but really confusing, given the fact that I’m used to the angry driver, as described above.

The skyline.

Chicago is extremely flat. I can think of one slight hill, in the middle of town on Halsted, which surprises me every time. Given the flatness of the terrain, you can see everything from anywhere. I mean EVERYTHING. I can see a tall man’s bald head from two miles away. When I’m biking to school I look over to my left and there’s the Chicago skyline! The one I’ve seen on postcards and photographs all my life. It’s a beauty, and after a year of being here I’m not used to it yet. And the best part is early in the morning, when the sun’s just coming up, (this doesn’t happen a lot, but there’s the occasional surgery that starts at 6:30am), it rises behind the buildings, and it’s orange. It’s totally orange and pink. The city’s on fire!

The fellow biker.

No matter how fast you think you’re going on the road, there’s always some guy in tight jeans, hipster glasses and a one shoulder satchel (that will give him scoliosis when he grows up, if he grows up) who zooms by at, I swear, 30 + miles per hour. Maybe it’s the fact that he doesn’t eat much and can therefore propel himself forward at almost the speed of light. Or maybe it’s the fact that he’s already 20 minutes late to his meeting at the bike shop where he works, but that guy, THAT GUY, will always pass you, and not even look your way.

Then there’s the maniac signaler. Who is not only signaling, but screaming “RIGHT RIGHT RIGHT RIGHT!” Who is she talking to? Not the drivers, because their windows are shut and they’re listening to the radio anyway. Maybe they’re talking to the dog or the squirrel that’s about to run in front of them. Or the pedestrian, so they don’t run ‘em over? I mean, I’m all about arm signals for bikes, but the yelling? Overkill.

 

So these have been my experiences as a Chicago cycling commuter. Every day there’s a new surprise- like the dog-pulling-owner-on-bike scenario, or the human-on-bike-pulling-dog scenario (which I saw today). Or the skateboarder who thinks he’s a biker, and takes up the bike lane. Or the pedestrian who simply refuses to acknowledge you and crosses the road, causing a near miss. (I hope I never hit a pedestrian, that would be embarassing… ) What will I see next?

A whole new 3D world

I created, or modeled, my first 3D living thing this week! It is a mouse embryo. No, I did not choose to create a 3D model of a mouse embryo. It is not a beautiful thing, and it is in fact a little bit gross. But it was an assignment in my 3D space modeling class in which we’re learning the program called “Maya.”

Maya is used by Pixar to create a lot of their animated movies. The finished products certainly have a certain feel and look to them, despite the vast amount of controls Maya gives you in terms of shading, coloring, texturing, lighting, etc.

Here are a few screen shots of the process, and my current end product. I hope to mess around with it a little bit more and sculpt it more to refine it. Then I’ll set up some lights… and camera, action! No, the mouse embryo will not move. It will just sit there, perpetually in 3D space.

the mouse embryo at its beginning stages, having started with a cube and built from there.

wire mesh of the mouse embryo

You can see in the background of the above picture that I imported an image of the embryo to use as a reference for size and shape. The blue shape is the model that I’m building. To create it, you start with a basic polygon shape, and “extrude” the edges and faces of the shape to build more and more of the mouse. You can manipulate every single edge, vertex and face of the surface, which should ideally be made of four-sided polygons.

It’s all still pretty overwhelming to me, and there is a TON to learn! Maya has like 50 bajillion buttons and tools. Hopefully I’ll model an organ or biochemical process for my main project in the class, or perhaps even a big toe!

current mouse model- it looks a little sad? Don't cry, little mouse embryo!

Surgical Stories

“Were there any good ones this morning?” asked my illustration professor as I passed him in the street.  I had told him that I just came from an early morning session of drawing in the Operating Room at UIC.  My response was at first cheerful and satisfied, “Yes, a mastectomy!”  But then I hesitated.  And my prof was having the same thought going through his head.

“Good for you, not for her,” he said.

I agreed.  I had had a frustrating morning of rising early to watch a surgery for 2 ½ hours that turned out to be a different surgery than I thought- the surgeons had switched rooms before I got there. I waited for that “key moment” that our surgical illustration professor tells us to watch for and illustrate… and it never came. I was looking for the wrong thing!  Strangely, both the surgery I intended to watch and the surgery I ended up watching had to do with an incision in the neck. So, innocent mistake. At least it was me mixing up the surgeries, and not them!

That’s why I was pretty delighted when I walked into the room where the mastectomy was to take place and the surgery was about to begin. It was taking place an hour later than scheduled, and I had gotten lucky. So I introduced myself to a nurse as a medical illustrator, and she said it’d be fine for me to stand in and illustrate, but that I shouldn’t touch anything blue.  All of the blue material in the room was sterile, and the clean instruments sat sparkling on the blue surfaces.

I stood next to a third year medical student who was also observing the surgery. He and his co-student were switching off between observing and partaking in surgeries that day. It was his turn to watch. His partner held the instruments and did some of the suturing at the end.

It turned out to be a wonderful subject to draw, since the surgery was “open” (not through a scope and using a video camera), the surgeons weren’t standing in my view, and it incorporated figure drawing as well as the depiction of instruments.  It was not a full-blown mastectomy–it was “partial”–which means they opened up the breast and removed the cancerous material.  They called the blobs of fat “specimens,” and poked and prodded at them before sending them off in sterile bags.  I will not describe the surgery any further, but the key steps are illustrated below in some sketches, if you’d like to see.

incision and retraction- opening up the breast for removal of tissue

clean up, exploration, blunt dissection by surgeon

The extracted sample and suturing the incision

closure of the incision

From Leeches to Lidocaine

I’m taking a class called Surgical Illustration, where I get to go into the operating room with a sketch pad to observe and record various surgeries. As a fly on the wall, I’ve come to see how advanced surgery has become. Most surgeries are now “endoscopic,” which means the surgeons don’t even have to cut open the person to move things around, cut or suture.  They make a small incision to insert a video camera, or scope that has its own source of light, and another small incision to insert special tools that are easily manipulated from outside the patient.  Some surgeries are completely robotic.  For most modern day surgeries, the patient feels nothing, and has a quicker recovery than ever before. What’s next?

Ancient surgery consisted of treating wounds and a thing called trepanation- the act of boring holes into the patient’s head, a procedure believed to release pressure and “evils” of a sickness. (although some believe ancient physicians were more deliberate and knew the science behind the surgical act.)  Can you imagine if modern day lawyers had been around during that time?  There would probably be lawsuits up the wazooo.

The foundation of modern surgery was, in fact, the barber.  With manual dexterity from cutting and trimming and shaving heads, the barber had the skills and tools to conduct basic surgeries like teeth-pulling or bloodletting.

An ancient bloodletting chart

 

In fact, the red and white striped pole originates from the two roles of the barber- red for surgery and white for barbery.

A breakthrough in surgery came with the first human dissections, which took a while to be accepted because of beliefs and religion. It also was a difficult task back in the day due to lack of refrigeration or sterilizing techniques.  A guy named Galen was a chief physician in Roman history during the second century AD and was named the “father of anatomy.”

He actually only dissected monkeys and pigs, but discovered a lot about medicine from these dissections, and was one of the first supporters of the theory that the brain controls the muscles of the body.

Much much later, Da Vinci became the father of accurate human anatomy, because he actually dissected human cadavers.

He did this controversial work in his own home, creating magnificent illustrations of anatomy that he never published during his lifetime. Andreas Vesalius, a Flemish anatomist and physician living around the same time as Da Vinci, stole bodies from graves to study them, and produced a book called “De humani corporis fabrica,” which corrected a lot of the errors of Galen.

Further breakthroughs in surgical history include the invention of the clamp and ligamenture by Amboise Pare in the 1500′s, which replaced the age-old techniques of pouring boiling oil onto a wound to stop the bleeding. Another one was the practice of hypnotism and use of alcohol for pain relief, and use of ethers and chloroform as anesthetics, adopted in the early 1800′s. Before then there was no such thing as an anesthetic!

Handwashing has its own history.  Ignaz Semmelweis lived in the mid 1880′s and developed the theory that a doctor’s hands were the cause of the spread of disease during surgery. He was ridiculed, and died of septicemia. (bacterial infection.)

Louis Pasteur later on discovered that bacteria caused decay, and finally a guy named Joseph Lister, born in 1827 in England, started using carbolic acid to clean his instruments before surgery, thus greatly reducing the number of deaths after a surgery.

I’m happy to say that I don’t remember the pulling of my wisdom teeth when I was 16. I remember waking up, drowsy from the anesthetic, awaiting my pain medication. 100′s of years ago I could have easily died from this surgery.  Thank goodness for these breakthroughs!

Good Practice.

Due to my interest in practicing medicine in addition to illustrating it, I signed up to shadow some clinicians and volunteer at a local community center in Chicago this semester.  A few days ago I shadowed a doctor who works the evening shift for family medicine.  Dr. W, I’ll call him, is a great family doctor because of the effective way he communicates medicine and health to his patients.

Many of the patients at the clinic have zero health insurance.  Many of them also don’t have the time, money, education and health literacy to always get the best care, not to mention to manage their own health.  Health literacy has been described as “the ability to understand and act on health information.” (Jibaja-Wiess, 2007)  I’m curious if the health literacy of a patient is actually related to how healthy they are.  Because we all know that donuts are bad for us due to the fat content and hardly any nutritional benefits, yet we eat them! (or I do at least, any chance I get) Apparently our country runs on donuts.

In one instance, Dr. W treated a young patient with a history of anemia who was having dizzy spell during sports practice.  (I’m maintaining anonymity with names, gender and other specifics for privacy purposes.)

Dr. W asked the patient if they had been taking the 3 iron pills prescribed to them a day, and the patient responded, “not really.”  He found that the patient was only taking one, maybe two pills per day.  This was a bright high school student with an education that probably included basic sciences.  But the patient didn’t take all three pills because they didn’t have a firm grasp of the point of taking them.

Dr. W asked the patient if any doctor had every explained to them how the iron pills were related to the dizzy spells.  The patient said no.  So he spent about 5 minutes explaining the role of iron as a carrier of oxygen in the circulatory system, and how feelings of dizziness and weakness directly correspond to the low levels of oxygen being delivered to the patient’s muscles, tissues and brain.

Afterwards, the patient said, “that makes so much sense!”  So, in the ten minutes it took to treat the patient, Dr. W had used science to convince the patient to take their pills.  It was like a light switch being turned on.

The problem is that many doctors don’t take the time (or have the time) to explain the science behind the health to their patients.  Some health care workers hand out informational sheets that, according to Dr. W, end up “lining the bird cages.”

One alternative to teaching patients about their disease is something like a disease management program in the form of a DVD or computer interactive.  Management programs can teach patients about their condition and how to treat it.

My masters project will be to create some 2D animations for a diabetes management DVD, for low health literacy patients.  The animations will, as clearly as possible, describe the role of insulin and glucose in diabetes.  The point is to show patients what their medication does and why it’s essential to warding off diabetes.  It will eventually be implemented on computers in clinics and hospitals so that patients can see and learn directly before or after their doctor’s appointment.

Lucky for me, shadowing in the clinic is a great way to see where exactly a disease management program can fit into community health care!

 

Jibaja-Weiss, M. L. (2007). Utilizing computerized entertainment education in the development of decision aids for lower literate and naive computer users. Journal of Health Communication, 12(7), 681-697.

Education in a Flash

Adobe Flash is used to create interactive programs, either web-based or on their own.  Any time you see a pop-up add online that says “click here for a better body!” or something like that, Flash was most likely the tool to create it.  So in that way, Adobe Flash is resented by a lot of internet users.  But I have grown to really like the program, because as with most things in life, it can be used for good as well as evil. (ok maybe “evil” is overkill for describing online pop-up adds, but they are really really annoying sometimes.)

Flash has a bouquet of capabilities including painting, drawing and editing tools, capacity for vector and bitmap images, means to create 2-D animations and it’s very own language, Action Script.  While I am far from being an expert in code languages, I have learned a little bit of html and css, and Action Script seems to be more straight forward than the others.  Using the language, you can tell animations to “start” or “stop” at the click of a button, to navigate through the pages of an interactive program or website, and way more complex things like to do something (say, play a certain happy song) on the condition that five other things are done, and if all five aren’t done, then doing some thing else (say, playing a sad song.)  I have found to really enjoy writing Action Script and troubleshooting with it. It’s like a puzzle that I have to put together, and if one piece is missing, the interactive just won’t work.

Here are some images of the interactive I made.  I created it to target a female audience, and specifically those who might be suffering from a disorder called Pre-menstrual Dysphoric Disorder.  You can read more about it here http://www.womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

…but for now I’ll just show you some images of the interactive, which teaches a little about what foods to eat and lifestyle choices to be made during the two or so weeks before your period.  It has four total pages, the last one being a quiz that you take after reading the information.  I hope that soon I can post the actual interactive so people can click through it and take the quiz!

Home page with options to click through the interactive.

"Diet" page, listing food recommended for those suffering from PMDD.

"Lifestyle" page, listing activities recommended or to be avoided.

"Quiz" page, where you can solidy your understanding of diet and lifestyle choices.

Brutal Illustration

Circumcision complete! Wait… I mean, I drew it. We had a critique today for the two projects due for my surgical orientation class. They were both drawings, one of which had to depict 3 medical instruments and another a procedure of our choice, and I chose circumcision.

Here’s my final illustration:

The first comment was from the only guy in our class, who said “ouch.” Later, someone presented an illustration of a masectomy, which I felt like was payback for me showing a circumcision.

The tool being used is this crazy thing called a GOMCO clamp, which is tough to draw, but only half of it is shown in the step above.

I also drew 3 medical instruments in Illustrator:

The first one is a scalpel, posed for by my helpful roommate. The second is a retractor, used to pull back someone’s anatomy during a surgery. And third is a very long set of weird forceps, which I had to crop to be able to get a nice view of the box joint.

I hope I didn’t scare anybody off!

Can’t just eyeball it

One project done! For my Clinical Sciences class, we had to draw an eye cross section.  A woman from the eye clinic next door–who serves as a full time medical illustrator over there–gave us a bunch of rules about how to NOT draw an eyeball, and showed us examples of artists who had gotten the eyeball wrong. Coincidentally one of the examples she showed was an illustration completed years back by our current professor and director of the program- who was in the room.  Haha. So we learned a lot about how to get the proportions right, how to correctly show where the retina terminates, and how to depict the optic nerve at the right angle. Here is the result of the tutorial we did in class using a ruler and a compass:

The assignment was to scan it into illustrator and create a vector drawing of the eye, with or without color. Since I’m still getting used to Illustrator, I chose to keep it black and white, but to fill in some tone. Here is my final eye ball!

Mr. Information

Another interesting talk today, this time in my Clinical Sciences class, which is a 1 credit class giving us a melange of seemingly unrelated information. (Please excuse the hold up on any actual drawings this semester- i’ve been bogged down in pathophysiology and medical terminology text books and the UIC library! I will have to show some art to in the next couple of weeks because everything is actually DUE. eek!)

So far in the Clinical Sciences class, we’ve:

1) learned the neurology of the human brain (abridged version) from an anatomist at the university during the course of two lectures,

2) met and learned from an amazing woman pretty high up in the pharmaceutical field, who told us really crazy stuff about drug development, (maybe another blog) and

3) heard a talk from this guy who works in the department of Biomedical and Health Information Sciences- right next door to us. That one sounds kinda boring, right?

It actually wasn’t boring at all.  He’s the guy who’s implementing electronic records in every hospital and doctor’s office in the country (mandated by Obama in 2008).  He’s the guy who wants to let everyone have access to their own health record, and let all doctors who treat you see your entire health history every time you enter a doctor’s office.  He’s also the guy that realizes this vision is a little unrealistic.

Why? Well, because it’s TOO MUCH INFORMATION.  Apparently, when they tried to give people access to their EHRs, electronic health records, less than 10% of them actually glanced at it.

He said, and I quote, “The data challenge in clinical care and medical research is huge.”  Meaning, there is way too much of it.  We have so much information on the genomes of thousands of species, we have the entire medical history of millions of people (not public I hope) and even more information about drugs, disease and treatment.  So what’s the use?  How can informatics be simplified to produce decision making?  For the doctor- and the patient?

One cool thing that Google has been a part of is the Google Flu Trends.

Every time anyone in the world Googles words like “flu symptoms” or anything related to that, it’s recorded.  Doctors and public health people watch the trends, and can predict a flu outbreak 24 hours before it happens.  It worked with the swine flu!  But the problem is that they never know if a “fluctuation” will become a steady rise, which, in the case of the swine flu, surprised quite a few people.

So I think the point of this guy’s talk was to inspire us to subscribe to his grand vision of: Using information to decrease complexity in health.  How do we do that?  Well, as medical artists we can use our graphic art skills to, say, simplify the Drug Facts.  Or maybe find a way to communicate to patients what is going on in their bodies in a clear and concise way, so they have the motivation to take their medicine.  To design based on purpose, ease and effectiveness.  Because humans are pretty complex, but we have limitations to what we can absorb and understand.  I totally agree, but I don’t know where to start.

Staples, surgeons and geckos

Today, a recently retired gastrointestinal surgeon came to speak to us about surgery in our class called “surgical orientation.” This class targets those of us who plan to take the fall class, “surgical illustration,” (ME!), where we go into operating rooms to sketch surgeries. So I would say that the topic was pertinent.

Dr. P (as I’ll call him) ended up teaching us more then we paid for. He has had a full career as a surgeon, having spent most of his practicing career here in Chicago at Cook County Hospital. But not only that, he himself is an artist. At the end of his very informative talk, during which he demonstrated the use of multiple modern surgical tools like staplers and sutures, and how to remove a part of the intestines, he brought out his portfolio.

And I expected medical illustrations, given his extreme exposure to the operating room and knowledge of probably 100’s of procedures by heart. But no! His portfolio was chock full of lizards, snakes and geckos. “I know I shouldn’t say this, but I don’t really like medical illustration,” he said to us. Instead, his passion is drawing reptiles.

Who is this man? To many, he might sound crazy, a little nuts, off his rocker, for pursuing not only surgery but also art- for spending his “free time” from operating on humans painting geckos. But to me, I feel like I’m the child he never had. All I wanted to do was ask him a thousand questions. When did you start drawing? Why didn’t you just become an artist? How did you decide between art and medicine? How does art help you as a surgeon and surgery help you as an artist?

He said it was hard for him to decide but he knew he wanted to do both, because, in his words, “I had other interests.”

I’d say.

He said that art has made him able to see the whole picture of the human body, and to relate the figure with what lies underneath. As a surgeon, he has a better idea of what organ is where (which might be helpful when cutting someone open) and as a painter, he has a better idea of the function of what he’s drawing from the outside, which gives him a more confident drafting hand.

And then the last thing he said was, “Just don’t forget, we’re all going to die.”

And while it might sound a little morbid out of context, I knew what he meant. He meant, do everything you want to do. Do it all. Because in the end, you don’t want to say “I wish I had done that.” So those are the wise words of the day, which hopefully I won’t forget tomorrow when I’m feeling overwhelmed by homework and drawings of circumcisions.

Page 4 of 512345