a ceremony of appreciation

Invited by Dr. Jen Hartmark-Hill,  I make my way to downtown Phoenix for a Ceremony of Appreciation. The event, organized by the Medical and Allied Health students at the University of Arizona, College of Medicine, honors individuals who donate their bodies to the anatomy lab.

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Upon arriving I meet Dr. Rebecca Fisher, the director of the Clinical Anatomy lab. She tells me about the personal connection students have to a willed body donor. She shares both the educational aspects as well as some of the emotional impact the experience holds for everyone. I look around the room as we talk and I see students, faculty and their families (newborns are in the mix too). The energy is celebratory as everyone prepares.

The evening includes art, poetry, prose, and music (ukulele, piano, song and dance).

One student names his donor Bruce. You looked like a Bruce to me, he reads into the microphone. Another student tells of holding the hands of her donor and notes the nail polish, chips of color. One guesses the age of his donor and wonders out loud, are you a grandfather?

There is practical (medical) information they gather from their donor’s body along with a natural wonder and  curiosity about the life it held.

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I can’t help but make connections between art students and medical students and their draw to the human body. I have to wonder, do they learn about Leonardo da Vinci in medical and science labs?

The medical students describe the learning experience as 2D (text book or diagram) and compare it to 3D (real-life) experience. Artists use a similar language. Art students study Anatomy (for the artist) to understand the skeletal and muscular system. The study is followed by Life drawing where art students apply what they’ve learned to a live model. Learned and necessary skills to both medicine and art are observation and attention to detail.

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And speaking of detail…
The student who draws this skull and heart ↑ is named Dylan. I introduce myself to him and congratulate his fine work.

I appreciate the imaginative way he personalized the drawings (of his donor). Dylan includes the usual anatomical description seen in medical illustration like frontal bone and then he adds more individualized (and more telling of the human-being) descriptions like bank teller, sweet toothjeopardy loversingle mother, grandmother…etc.

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As I thank Jen (Dr. Harmtark-Hill) for inviting me, we agree the evening is moving and meaningful. And before we part for the evening  she mentions an approach to education that she calls  Appreciative Inquiry.

 I often speak with my colleagues about the fact that we are privileged to teach these medical students—they are incredibly good and altruistic individuals. If we can find ways to protect that compassion, kindness and caring throughout their medical training, while instilling knowledge and skills, we will have done their future patients a great service.

I understand Appreciative Inquiry to be a way of seeing (worldview) and a way of being (process) that supports the goodness in people (individuals, organizations and communities).

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A letter written to a donor and expressing gratitude.

Thank you Jen for inviting me to this most extraordinary ceremony. And thanks to the students for a creative and moving evening.


As I come to the end of my post I can’t help but think of a phrase that influences the work I do. I know with certainty it directs me to unique experiences like this one.

Summum bonum is Latin and translates to the highest good.

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foot notes*

My feet. Still.
More complex than I under. Stand.
Layer upon. Layer.
Points of contact. Mother Earth.
Conductors of.  Magical.


*These are my notes, written as such.

My studio skeleton sits in parts, on my drawing table. I’ve pull the hardware out, separated and laid out the bones. I take a good look at the long and elegant leg bones before moving to the feet.

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Top photo: Femur, aka the thigh bone ↑, is the longest and heaviest bone in the human body.
Bottom photo: The Tibia, aka the shin-bone, and the larger 1 of 2 bones below the knee. It takes all the weight of the body. The fibula, aka calf-bone, which has none of the strength of the tibia, forms part of the ankle joint.

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Bones are living tissue, made up of calcium phosphate and other minerals and collagen (fibers of protein). Minerals make bones hard, collagen makes them flexible. And unlike the skeleton in my studio, hardware does not hold up the skeletal system. Muscles (with the help of tendons and ligaments) hold bones together (can I call the latter software?).


The feet are my current study. Intricate. Wonderful.
The human foot has 26 bones, 33 joints, 107 ligaments, 19 muscles and tendons. A total of 52 bones in your feet make up about 25 percent of all the bones in your body. I gather this information before I begin working. That’s a lot of stuff to organize into one composition.

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Bones of the foot – Plantar View ↓.  The top sections (above my finger)  are phalanges (love! the word). Metatarsals are the longer bones (between my fingers).
(Prior to the 16th century Vesalius called the metatarsals ossa pedi (bones of the instep), and before that Galen called the area pedian (‘the flat’ of the foot).)

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Bones of the foot – Plantar View

See the round knobby bones my finger sits on ↑ (in the drawing I circle them in green). Those are sesamoid bones (derived from the Latin sesamum – sesame seed). These small bones form in response to strain. They provide (like a pulley) a smooth surface for tendons (that bend the big toe downward) to slide over. I mull over that for a good while …wow. Sesamoid bones are found on various joints throughout the body.

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The mid foot ↑, below the metatarsals, is the area of bones forming the arches. These include the three cuneiform bones, the cuboid bone, and the navicular bone. The hindfoot forms the heel and ankle.

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Plantar View – sole of the foot

To appreciate complexity, I work a 2-sided drawing (of my feet). One side presents the sole of the feet ↑ (bones, tendons and muscles) while the flip side shows the top of the feet ↓ (nerves, arteries and veins).
(I get why Vesalius wanted to draw the body and its layers at all various angles.)

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Dorsal surface – Top of the foot

Feet: science and spirit, physical and subtle.

I hear someone say the feet have a consciousness (*bring awareness and care to your feet). They (*you) can learn how to take care of themselves (*yourself).

Stand. Be aware. Bear equal weight on all four corners of the foot – big toe mound to pinky toe mound, inner ankle to outer ankle. Align the second toe directly in front of the ankle. Then go.

Feet guide the knees and hips, acting as anchors to the earth.
They absorb.
They help us to ground and recharge (more than 7000 nerve endings – think about that!)

 

 

 

 

a profile

Profile –
: the shape of a head or face that is seen or drawn from the side
: the shape of something that is seen against a background
: a brief written description that provides information about someone or something


My mind wonders: Is this portrait a profile of Sophie or is this a profile of Trisomy 21? Both, all of it, I remind myself. I map Sophie, a real person.  I map Trisomy 21, a genetic disorder. I talk a lot about the science behind my work. Today I hope to give some attention to Sophie and to some drawing elements as well.

A profile of Sophie
I study photos of Sophie all summer. I ask lots of questions and read more information than I can recall. I have a niece named Sofia, I know the name means wisdom. I meet Sophie days after her 13th birthday. Summer break is ending and this week she begins middle school. Every time I come to the work on paper, I recall one of the last things she indicates at our initial visit. She’s a teenage girl and she wants to be just like every other teenager. She wishes she didn’t have Down syndrome. I can’t help but think about this every time I come to my drawing table.

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Portrait of Sophie, Side view

About drawing
When I begin, I can’t know how much I will enjoy working out this composition.  I practice everything I teach my students. I look closely and consider how to express best everything about Sophie: the defining contour and variety of texture within her complex structure. BTW, all structure in its uniqueness is complex. I don’t add anatomy to these portraits for a good while because I like how the simpler sketch expresses some personality. I photograph the process to hold these aspects of Sophie.

I work on paper. These details are in pencil – graphite and color, regular and water-soluble. I like this part so much that for a moment I consider teaching only pencil drawing. I laugh at the thought because anyone who’s studied with me knows they never see any kind of pencil in my class, much less draw with one.

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Profile of Trisomy 21
Down syndrome is a genetic condition that causes intellectual disability. I plan to include a brain from the start. An interesting find is the connection between DS and Alzheimer’s. I didn’t know early onset of 
dementia may be a factor in DS. I ask an MD friend to tell me the difference between Alzheimer’s and dementia. None, he responds. They basically mean the same thing. 

I am most familiar with the facial characteristics of DS. I observe some of the common traits of a smaller and flatter nose (bridge) and forehead. I am not convinced there is much of an upward slant to Sophie’s eyes, at least not in the photos I shoot. I don’t see epicanthal folds nor do I note smaller ears. I have to wonder if some people outgrow some qualities. Individuals are unique, I hold steady to this thought.

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Portrait of Sophie

Sophie shows me her fissured tongue (and I love drawing it). I don’t find this as a common characteristic but I learn big sister Annabelle researches the condition and in this case, it is DS related. Looking at drawings of a skull, I learn the mouth and jaw bone are smaller and palette narrower which cause the tongue to appear large. As I lightly lay in anatomy, I consider the smaller than average nasal passage ways which can make breathing difficult.

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Because Sophie mentions 2 heart surgeries, I initially consider 2 hearts in the composition. I reconsider when I find an EKG related to Endocardial-Cushion Defect. I already have the heart in the drawing, this element refers to that and is not only an expressive life-line but informative of DS as well.

All of my work is education based, this drawing is no different. I have a new respect for Science and all that it provides for us. But I do not let go of my respect of the Subtle Body and its energy, you know…the part about spirit and its fulfillment. I clean up at the end of each drawing session and leave my studio for the day and I can’t help but wonder if Sophie will live the life of a typical teenager. Each individual is unique. Hold steady that thought.

A side note
Title of artwork. A Profile of. A Portrait of. One more thing to show itself in time.

a heart in situ

Amy Silverman contacts me in February. She wants to have coffee and talk about our work and how it intersects. Our work intersects? Amy is managing editor of the Phoenix New Times.

We never meet for coffee though we keep in contact and on May 1st she comes to my studio.  Do you mind if I record our conversation? I’m impressed. Why don’t I think to do that when I want to remember things? Clearly we are trained different. We do a little catch up and then she tells me she’s written a book. She says it has science in it. We talk about my drawings and about how I write about my work. She refers to what I do as reporting. One thing leads to another and I make a plan to attend the upcoming book launch.

My Heart Can’t Even Believe It, A story about science, love, and Down syndrome is a story about her daughter Sophie. It’s actually about all of her family but in particular it’s about her youngest child born with Down syndrome.

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Amy tells the story of how her and her husband handle the birth of Sophie, and the life stuff that follows. She goes through medical details as they present themselves and as she tries to understand Down syndrome, also known as Trisomy 21.

She’s descriptive in a way that catches my attention. She takes what is complex science and makes it easier to understand (not easy, just easier). Her words have a visual impact on me. Every time she describes to the reader a physical symptom and/or procedure, my mind’s eye sees it (wants to see it).

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Amy and I first meet in the studio on May 1 and within a month (June 1st) I layout Sophie. I am working on a painting of my nephews daughter, my niece Pilar, who is 5. Because I have much to learn, I decide they’re good back and forth studies. I don’t have children and all of this is a type of learning for me. What is normal human growth and development? Do I use the word normal?  Will I use the words typical and atypical? Do I even use any of these words when I talk about a drawing?

While Amy writes about the more common features of Down syndrome and notes her daughter looks like other Down syndrome children more than like her own family, I see it different. Sophie is totally unique to my eyes. I look. And I have to look again.  I bookmark many things. As I work I go back to the book, to research material and to my notes. As with all my work – you learn as I learn.

Amy connects me with the Co-Director of the Pediatric Down Syndrome Clinic at Phoenix Children’s Hospital who generously makes herself available to me. I contact a research scientist who knows cell biology well. And I talk to a cardiologist who gifts me a couple of his medical illustration books by Dr. Frank Netter. One is about the thorax in general, while the other is about the heart in particular and includes the Atrioventricular Septal Defect that Amy describes in the early part of her book as a hole in her (daughter’s) heart. The book refers to it as Endocardial-Cushion Defect.

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The chapter’s name (the words above to the right) is where I get the title to this post. I have drawn the contour of Sophie’s complete body (studio shot in post). And as I go from part to part I can’t help but wonder how the 21st chromosome affects each and every one of her organs. Down syndrome associates to DNA (our blueprint) and an extra 21st chromosome, it is also called Trisomy 21. Right now – A portrait of Sophie, studying Trisomy 21 – is the working title.

I know the composition will include 2 hearts because the day I meet Sophie she tells me about her heart surgery – both of them. And she tells me about her feeding tube.

Thanks Amy, for bringing your work to my attention. And thanks Sophie for agreeing to let me map you. And thanks for the blue paintbrush you gifted me (If my memory is correct Sophie’s collection includes at least 300 paintbrushes). I refer to the color of the brush as turquoise (my favorite color) and Sophie corrects me, It’s more like aqua! She takes her mom’s cell phone and pulls up a color swatch. It’s true, the brush is aqua.

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Hey Sophie, do you know energetically, that particular blue is the color of expression and is found in the throat? It is.

For more about Amy and her book → My Heart Can’t Even Believe It.