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When conjoined twins Abbigail and Isabelle Carlsen were separated at the Mayo Clinic in May 2006, surgeons were guided by large wall posters showing the girls' overlapping hearts and shared liver, biliary system and intestines. The posters were created by Michael King, a medical illustrator who studied thousands of radiographs, CT scans and MRI images to learn the twins' anatomy. The posters served as road maps for the operation.

Visual Variety

Artists have created medical illustrations for thousands of years. But modern medical illustration originated in the late 1890s, when Johns Hopkins University hired Max Brodel to depict surgical procedures. The Mayo Clinic hired its first illustrator in 1907.

Today medical illustrations appear in journals, textbooks, in advertisements and on television. They are projected during lectures and classes, used on websites and are an important part of computed-assisted learning programs.

Although most illustration is two-dimensional, some medical artists work in three dimensions. Their creations include anatomical teaching models, models for simulated medical procedures and prosthetic appliances for patients.

Distilling The Data

Medical illustrators visualize information for healthcare professionals and patients. These artists zero in on the most important changes in tissue, the essential aspects of an anatomical area or the crucial steps of a surgical procedure. What they leave out is sometimes more important than what they draw.

After observing a six-hour surgical procedure, for example, a medical illustrator might boil everything down to three key steps. After studying a CT scan or an MRI, the illustrator would focus on the most important changes or physical characteristics revealed by the image.

"Medical illustrators are especially important now that we've entered the information age," says Bob Morreale, director of Mayo's medical illustration and animation unit. "That's because they can focus and distill data from complex, detailed images."

Surgical Planning

Traditionally, illustrations are created to document or educate. The use of medical illustration to plan and guide a complicated surgical procedure is unusual.

"In the case of the Carlsen twins, everyone on the 70-member surgical team needed to be on the same page," Morreale says. "So we created multiple illustrations, which the members of the team used for planning. During the operation, the surgeons were able to look up at the large posters of the girls' very small, delicate anatomy while they were operating."

Morreale expects that medical illustration will be used in the future to plan other unique surgical procedures.

Education And Outlook

According to the Association of Medical Illustrators (AMI), most illustrators have a master's degree in medical illustration. Only four accredited programs currently exist in the United States. Each accepts between three and 12 students each year. Students take medical science courses such as anatomy and physiology along with courses in subjects like drawing and computer graphics.

The employment outlook for illustrators is good, due to the growth in medical research and the need for patient education materials. Earnings vary depending on experience, type of work and geographical region. According to AMI, an experienced, salaried illustrator usually earns between $52,000 and $73,000 annually.

Learn More

• Association of Medical Illustrators. www.ami.org