Scientific Illustration

Surgeon Robert Jackler and medical illustrator Chris Gralapp have collaborated for over two decades to produce more than 1,000 illustrations for surgical atlases, books and journals.

“I counsel you not to cumber yourself with words unless you are speaking to the blind — how in words can you describe this heart without filling a whole book? Yet the more you write concerning it, the more you will confuse the mind of the hearer!”— Leonardo da Vinci

Every other week on Monday afternoons a container of colored pencils is placed prominently on the coffee table in the surgeon’s office. Nearby is a sketchpad. Such simple old-fashioned instruments, the pencil and paper. Then the surgeon and the artist enter the room, and the recipe is complete.

Even with the advent of all kinds of advanced technological illustrative and imaging devices, these are still the tools that medical illustrator Chris Gralapp and surgeon Robert Jackler, MD, use to illustrate some of the most technical of microsurgical techniques — hypoglossal-facial anastomosis, middle fossa craniotomy, and stapedotomy among others. Page after page of their drawings already comprise such tomes as Jackler’s Atlas of Skull Base Surgery and Neurotology, which explains the “how-tos” of surgeries deep inside the skull.

And it all begins with a crude pencil sketch.

“I’m a terrible drawer,” said Jackler, professor and chair of otolaryngology, who for years has arrived fresh from conducting surgeries — all in all, thousands of procedures removing cranial base tumors, restoring hearing, repairing eardrums and other problems — and begun describing in vivid detail to Gralapp exactly what he has done inside his patients’ heads. Often he scribbles on paper to help convey his thoughts. “I make my messy sketches,” he said, “And she brings them to life.”

Jackler, together with Gralapp, who has a master’s degree in medical illustration, has published three illustrated books on skull base surgery, and they are now working on a fourth, an exploration of middle ear surgery. The works are also available online, and the pair are going virtual, creating haptically enhanced 3-D videos with the help of Nikolas Blevins, MD, associate professor of otolaryngology, and colleagues in computer science