ArtMedicine: Science diagnoses art

(This article appeared on Medscape in February 2001.)

The bulge in the left breast is large and distinct. The nipple and areola appear swollen and the skin nearby looks dimpled–puckered. It takes Dr. James Stark exactly 2 seconds to make his diagnosis.

“That woman’s got breast cancer,” Stark whispers to his wife as they stand in Florence’s Church of San Lorenzo. He has just diagnosed the subject of Michelangelo’s 500-year-old sculpture called Night.

Over the years, art historians have suggested that the breast is malformed because Michelangelo was unfamiliar with female anatomy, or that it is the result of a sculpting error. But until June 1999–when Stark visited the chapel–no one had diagnosed the prominent lump.

“I’ve been . . . [diagnosing breast cancer] for 25 years. I looked at the breast for 2 seconds and I just knew,” says Stark, medical director of the Cancer Treatment Centers of America and associate professor of medicine at the Eastern Virginia Medical School. For the next 1 1/2 years, Stark and Jonathan Nelson–a scholar in Renaissance art and a visiting professor at the Florentine campuses of New York University and Syracuse University–thoroughly investigated Stark’s theory. Skeptical at first, Nelson has since become convinced that Michelangelo knew the woman had a fatal disease.

“The theory fits in with our general understanding of the statue,” says Nelson. The sculpture is in a funerary chapel, Nelson explains, and Michelangelo may have intended it to be a metaphor for the wasting death of Giuliano de’ Medici, who died of a lingering illness. The sculpture rests atop his crypt. Last November, Johnson and Stark published their findings in a letter to the New England Journal of Medicine.

New Field

Stark is not the first scientist to find disease represented in art. In the past few years, the field of what has been called ArtMedicine has found a growing audience, thanks, in particular, to the efforts of Dr. Carlos H. Espinel.

“ArtMedicine,” Espinel says, “is a new way of seeing art and medicine and seeks to humanize medicine.”

In the early 90s, Espinel identified the boy in Caravaggio’s Sleeping Cupid as having juvenile rheumatoid arthritis, a disease that had been thought by scientists to only have evolved in the last 100 years. According to Espinel, the cupid’s small jaw, twisted joints, and big abdomen are classic signs of the crippling disease.

“In medicine, we leave the humanistic approach out,” Espinel says. “The painting can teach us about the poor children who suffer from the disease–to look beyond the bumps.”

At first, Espinel’s theories were poorly received by both scientists and art historians. His results were rejected by the Journal of the American Medical Association and the New England Journal of Medicine–premier peer-reviewed publications in the United States. Finally, in 1994, the British journal, the Lancet, published Espinel’s article along with a color photograph–a first in the journal’s history.

Department of Art

Since then, the Lancet has created a Department of Art dedicated to the study and dissemination of ArtMedicine and has published several of Espinel’s findings, including

  • A diagnosis of Michelangelo’s gout on the basis of a fresco by Raphael.
  • Evidence of polio seen in a 1426 painting by the Italian painter Masaccio.
  • A diagnosis of Rembrandt’s arteriosclerosis based on his self-portraits.

Espinel now teaches courses in ArtMedicine at Georgetown University and Johns Hopkins and lectures across the world.

Since the early 1900s, art therapy has been used to help patients cope with illness. At least two scientific publications also use art as an accompaniment to their scientific content.

“Art is about beautiful things, but it is often about suffering of some kind–overt or otherwise,” says Elizabeth Meryman, art director for The Sciences–a bimonthly magazine that uses art to illustrate articles. Meryman chooses pieces of art that “tell a story, that evoke the mood of the piece.” A conjunction between art and science is possible because art is so rich in all these areas, says Meryman. “Art and science enhance each other.”

Espinel also says scientists could learn a lot from art. “Science is relatively a new discipline. But art has been around for 30 or 40, even 50,000 years. Scientists need imagination, the leaps of imagination that create art,” he says. “The most important observation of ArtMedicine is observation with compassion. At the end, if we put the two together, we can serve our patients better.”

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