Medical illustrators draw what cannot be seen, watch what has never been done and tell thousands about it without saying a word.

For decades, this slogan appeared on the website and printed materials of the Association of Medical Illustrators. Although the association no longer uses this tag line, it is still an accurate description of the profession.

I have been drawing what cant be seen and watching whats never been done on a daily basis for over 30 years, and teaching my students to do the same.

But what exactly does all of that mean, and how does it improve medicine?

You may have heard the adage, A picture is worth a thousand words. In that same vein, medical illustrators use pictures to teach complex scientific concepts. As the famed medical illustrator Frank H. Netter once said, pictures eliminate the need for the lecturer or the author to translate what he has in his mind into words and for the listener or the student to translate those words back into a mental image.

The use of illustrations to communicate medical information has a long history, dating back at least to ancient Egypt and flourishing in the Renaissance. The work of 16th-century anatomists Giacomo Berengario da Carpi and Andreas Vesalius set a precedent for the use of detailed illustrations to teach anatomy, a practice that continues to this day.

The proliferation of illustrated anatomy atlases in the Renaissance coincided with the widespread acceptance of cadaver dissection. The earliest known human dissections were performed in the third century B.C. The practice was prohibited throughout the Middle Ages but became common again in the 13th and 14th centuries.

By the 1500s, dissections, usually of executed criminals, had become public spectacles. Demand for bodies eventually outstripped the supply of executed convicts, leading to grave robbing and even murder.

In addition to depicting the location and features of objects such as organs, illustrations described events happening over time, such as the progression of a disease or the steps in a surgical procedure. Generations of surgeons learned new procedures from meticulously illustrated surgical atlases. An early example, William Harveys classic 17th-century work Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus depicts the direction of blood flow through the veins of the forearm.

Today, surgeons can practice a procedure hundreds of times using virtual reality before trying it on a real patient. Modern physiology and pathology texts include countless illustrations of the body, not just at the anatomical level, but also at the cellular and molecular. So valuable are these depictions of complex pathways and interactions that many science journals now require papers to include a graphical abstract, or single illustration that summarizes the content of each paper.

Medical illustrators employ special tools and training to visualize things that are normally hidden from the naked eye.

All professionally trained medical illustrators study human gross anatomy, including dissecting a cadaver, to visualize the internal structures of the body. Illustrators also use medical imaging, such as CT and MRI scans, to reconstruct the body in three dimensions.

At the cellular level, medical illustrators must understand how to use microscopy techniques to find references for accurate depictions of cellular structures.

Objects at the smallest scale atoms and many molecules are smaller than the wavelength of visible light. This means they are below the theoretical limit of what can be seen, even with the most powerful light microscope. So researchers experimentally determine the structures of molecules using techniques such as X-ray crystallography and nuclear magnetic resonance spectroscopy instead.

Medical illustrators learn to locate and retrieve data on the structure of molecules from sites such as the RCSB Protein Databank. They also use a host of visualization software to render them in 3D.

Medical illustrators at the U.S. Centers for Disease Control and Prevention used these techniques to create the famous red-spiked coronavirus image that went viral during the pandemic.

Obviously, you cant really watch something that has never been done. But medical illustrators can help conceptualize new processes and techniques before they become a reality.

For example, they might illustrate how an experimental drug could theoretically work before it enters testing. Similarly, illustrations can be critical in pre-surgical planning, such as for the separation of conjoined twins Abbigail and Isabelle Carlsen at the Mayo Clinic in 2006. Working from nearly 6,000 radiographic images, the clinics medical illustrators produced five detailed illustrations of the twins anatomy. They even generated 3D-printed models, notably of their shared liver.

The illustrations were critical in training the 70 surgeons, nurses and technicians involved in the case. They also served as a road map for the ultimately successful surgery, hung up on the operating theater walls during the procedure.

To draw what cant be seen and watch whats never been done, medical illustrators require specialized training. Most medical illustrators in North America are trained at accredited masters programs. Accepted students must have a strong science background and a portfolio demonstrating outstanding drawing skills.

Once in the program, their science training continues with some combination of courses in neuroanatomy, embryology, histology, cell biology, pathology and immunology. Specialized courses in surgical observation and cellular and molecular visualization also include significant science content.

Students receive extensive training in computer graphics, including 2D and 3D modeling and animation, interactive media, virtual and augmented reality, and educational game and mobile app design. Courses also emphasize the principles of design to create effective visuals.

Medical illustrators learn to consider the educational level of their audience. Illustrations made to educate a child diagnosed with leukemia would be very different from those aimed at the oncologist treating the disease.

Many medical illustrators pursue board certification to become a certified medical illustrator, which recognizes professional competency. Continued certification requires continuing education in the biomedical sciences, artistic techniques and business practices.

All of this education and training is essential to ensure that medical illustrators communicate complex scientific information with accuracy and clarity. I like to think of medical illustrators as teachers we instruct with pictures.

James A. Perkins is distinguished professor of medical illustration at the Rochester Institute of Technology.

This article was produced in collaboration with theconversation.com.

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Medical illustration draws on knowledge of anatomy, cell biology, more - The Washington Post