The body is multidimensional. Normal physiology and disease are at least four dimensional — including time. Classical medical education, including mine, begins in the gross anatomy laboratory with a cadaver dissection. Rembrandt’s “The Anatomy Lesson of Dr. Nicolaes Tulp” shows students of almost four hundred years ago looking at the dissected muscles of the arm. In my anatomy lab we dissected with a guide book, comparing the two-dimensional pictures in atlases that suggested the third dimension of depth. The ubiquitous and terrifying medical school exams tests frequently asked, “If a probe were stuck through a particular muscle and entered the spleen, list in order all the structures through which that probe would pass.” Conceptually, not too different from Dr. Tulp’s instruction. With time and technology , there developed 3D reconstruction of the entire human from one millimeter thick sections, such as “The Visible Human Project”; those individuals who are not three dimensionally challenged can begin to see multiple spatial relationships.
Dermatologists are familiar with the three dimensional wax models, or moulages, which are part of some departments’ historical collections; there is a grand collection in the Hôpital Saint-Louis in Paris. Wax molds of affected body parts were delicately painted with life-like colors, and learners could compare their patients with the standards described by their professors. This was an effective 3D approach before the three-dimensional technologies of today.
We might seem to be going backward, or maybe sideways, as described in a recent article in The Scientist. Beautifully realistic, three-dimensional artwork is painted on the skin, depicting underlying anatomical structures, including muscles, vessels, and nerves. The muscles look like the écorché (or flayed) figures of renaissance anatomists and artists. There is a dimension of time in these reconstructions, as well: first, because the painted individual can move, and second because the images are ephemeral, lasting only a day. Looking at a live human on whom these educational reconstructions have been painted will no doubt be highly motivating for students, and surely the urge to touch the skin will be immense. I envision the fourth dimensional coming to these paintings so one can visualize muscles contracting, blood flowing in vessels, and wounds repairing themselves. The interface between the artist and the scientist certainly will lead to new insights about the human organism.
jidjottings, by Lowell A. Goldsmith, MD 