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Pathology Reveals Intersection of Art and Medicine

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Photo courtesy of Josh Sickle

When pathologist Josh Sickel, BS biology ’78, looks through his microscope, he sees art. To him, patterns of mutated cells are akin to compositions on canvas.

On examination of a biopsy, says Sickel, he makes a diagnosis that becomes the basis for treatment. “This has a significant and life altering impact on a patient, it’s something so serious. Yet when you look at the images alone, they are aesthetically quite beautiful.”

He likens the experience to visiting an art gallery. “It’s magical and mysterious to be able to look at a slide. I can literally tell you how this patient is going to respond to chemotherapy or if it’s something for which we must give antibiotics. It’s miraculous to look at pictures and be able to make powerful predictions.”

Sickel founded El Camino Hospital’s Healing Arts Program in Mountain View, California, in 2002. Disease is his focus, of course, but he also is interested in the power of art, music, and laughter as therapy to ease pain. Committed to making pathology less esoteric and more accessible to nonmedical people, Sickel regularly lectures to community groups in the hope of breaking down barriers between doctor and patient. He uses slides to illustrate these questions: how can art make sense of science, and why do we choose to look away—or more closely?

Pathologists use analogies and metaphors to help them remember specimen patterns. Sickel says audiences are stunned when he juxtaposes an image of Van Gogh’s “Starry Night” with that of malignant lymphocytes punctuated by phagocytic macro- phages, which gobble up dying tumor cells. The patterns are strikingly similar, with the macro- phages mimicking Van Gogh’s stars and the lymphocytes his swirling sky.

Astronomy inspires another analogy. “When you’re a kid, the night sky all looks the same. But then somebody points out three stars in a row and tells you that’s the belt of Orion.” Pathology, he says, is very similar. You pick out patterns and you name them. Mastery comes with practice, just like learning to pick out a constellation in a starry night.

Sickel’s background clearly influenced the way he sees. His father was a psychiatrist and his mother was a docent at the National Gallery of Art. As a kid, his favorite game was Highlights magazine’s “Find the Hidden Object,” which he believes helped to train his eye to make accurate diagnoses.

When he was in high school, his mother encouraged him to learn about art. One day, while flipping through a coffee table book on modern art, he discovered that he was quite good at remembering painting styles, which enabled him to identify the artist.

“I’d look at each picture and quiz myself: Matisse, next; Renoir, next; and so on. And then I’d come back several days later and test myself. I think I primed my visual cortex to be really good at pattern recognition.”

Sickel graduated from the University of Maryland–Baltimore medical school in 1984 and completed a four-year pathology residency at the University of Rochester and a one-year fellowship at Stanford University.

“I went into medical school for the same reason a lot of people do: We’re fascinated by how the body works, how and why we get sick, and the desire to help people heal,” he says.

“To be a pathologist,” he admits, “it helps to have a vivid imagination.” Sickel tries to reconcile the inherent paradox: that something can be so beautiful and so tragic at the same time.

“Authors, playwrights, poets, and artists deal with this all the time,” he  says. “These are very unpleasant, unsavory issues—and yet presenting and reflecting on [the] beauty may soften the edges of these otherwise very serious issues.”