A Medical Lesson in Observation and Diagnosis through Art

The intersection between science and art is often overlooked, rather than appreciated. While medical tools and art supplies are not entirely comparable, before MRIs, X-rays, and blood tests, there were brushes, paints, and canvases. During that time, the limited technology and basic understanding of medicine may have hindered precise diagnoses, but the illnesses and diseases themselves still existed. The physical symptoms of such disorders have been documented throughout history, perhaps unknowingly, using careful observation and detailed brushstrokes. Artists were capable of accurately depicting the rashes, pallor, and facies of diseases that were unknown at the time.

Recently, modern day physicians have been exploring the intersection between art and science. By “diagnosing the canvas,” they apply their medical training to famous works of art, and theorize possible diagnoses using evidence from the painting right in front of them.¹ An array of diseases and illnesses have been observed in a number of medical specialties. In paintings dating as far back as the 16th century, physicians have put forth possible diagnoses for figures depicted in artwork. In Rembrandt’s self portrait, which is on display at the National Gallery of Art located in Washington, D.C., he carefully depicts himself with elderly skin. To the eager museumgoer, Rembrandt simply seems to suffer from the inevitable effects of aging. However, to the medically trained eye, Rembrandt’s skin may point towards an array of dermatology-associated disorders. Others have hypothesized that the textured skin, obesity and an assortment of other physical symptoms may in fact indicate an underlying endocrine disorder.²

The abstract and illusory nature of art offers a whimsical twist on our outlook. Sometimes, these seemingly abnormal depictions of dancers, flowers, or everyday sceneries can also illuminate an artist’s view of the world. In some cases, visual or neural pathologies of great artists can be traced back from the canvases that hang in famous museums.

Let’s revisit the same Rembrandt self portrait, and now consider the artist’s own perception of himself. Both eyes function to allow stereovision, or the ability to perceive three-dimensional depth on a daily basis. In his self portraits, Rembrandt often portrays himself with misaligned eyes. One eye looks directly at the viewer, while the other eye often gazes to the side. Whether it’s the right or left eye that points directly at you or looks off to the side depends on which of the many dozen Rembrandt self portraits you are looking at. Two neuroscientists at Harvard Medical School made the initial observation. Upon measuring components of Rembrandt’s stare in several dozen self portraits, they concluded that the artist likely lacked normal stereovision. In other words, if this diagnosis was true, Rembrandt struggled to visualize depth in his everyday life.³

Many other examples of medical diagnoses made from artwork have been documented. The works of talented artists from centuries ago provide potential insight into the pathologies of both the subjects and the artists. These works also offer a unique educational opportunity. Not only have specialized physicians been identifying medical conditions in famous works of art, but some medical school programs have incorporated “diagnosing the canvas” into their curriculums. A little over a decade and a half ago, the Yale School of Medicine pioneered a medical education program dedicated to teaching first year students the importance of detailed observation. Today, approximately 70 medical and nursing schools in the country use art to enhance diagnostic and descriptive skills. After several minutes of observing the painting, students reconvene to recap their observations and put forth their diagnoses in a group discussion.

Identifying illnesses and diseases in historic works of art through a modern medical lens can prove challenging. The concluding diagnoses remain speculative, which can parallel the uncertainty that students will face during their medical careers. The exact pathologies depicted in artwork will remain a mystery, allowing students to tap into their creativity and consider multiple narratives.⁴ Being able to consider different medical possibilities, each rooted in observation, will hopefully enhance patient diagnoses and outcomes. The foundational bridge between science and art has been established, but now it is time for us to walk across it.

References:

1. Daley, J. (2016, May 26). Doctors diagnose diseases of subjects in two famous paintings. Retrieved from http://www.smithsonianmag.com/smart-news/doctor-will-frame-you-now-mds-diagnose-diseases-two-famous-paintings-180959227/
2. Salter, V., Ramachandran, M. (2013). Medical conditions in works of art. British Journal of Hospital Medicine, 69(2), 91–94. doi:10.12968/hmed.2008.69.2.28354
3. Martinez-Conde, S., Macknik, S. (2015, March 1). Famous paintings can reveal visual disorders. Retrieved from https://www.scientificamerican.com/article/famous-paintings-can-reveal-visual-disorders/
4. Oksman, O. (2017, May 25). Old works of art are helping med students learn how to diagnose. Retrieved from https://tonic.vice.com/en_us/article/wje9nw/old-works-of-art-are-helping-med-students-learn-how-to-diagnose