Several years ago, a non-medical friend, Rama, was diagnosed with pancreatic cancer. Rama asked me to come to her appointment as a friend, but more importantly, as her medical translator. Rama’s kind doctor was very compassionate. Yet, she used complicated words like metastases and hepatic lobe infiltration. With Rama watching, the doctor scrolled through a CT scan of her abdomen on the computer screen. The doctor showed Rama how extensively her cancer had spread. To Rama, it was overwhelming. (Left image is not Rama’s; it is off the internet from an article in Lancet).
You see, Rama knows her body like the rest of the non-medical population–at a second-grade level. She did not know what her pancreas was, let alone where it was or what it does. How could she possibly understand the complicated CT scan the doctor had shown her? She did not even understand her own basic anatomy.
I felt bad. When I took her home, I took out my pen and paper and began to draw. First, of her anatomy. Then, of her cancer. And finally, of her treatment. Only then, did she truly understand what was happening to her body. Empowered with this knowledge, she told me that she now felt strong enough to think about fighting her disease.
I had always been drawing little sketches for my patients to explain complicated concepts. However, after I saw how helpful it was for Rama, I began to draw even more. I drew gallbladders. I drew kidneys. I drew intestines. I drew bladders. I drew uteruses. I made it a point to try to draw an image for each patient on the whiteboard in the room.
After I started drawing frequently, I began to notice something. People started asking questions. Intelligent questions. Logical questions. People began to understand what was going on inside their bodies. They began to understand how their disease worked. With a simple sketch, they actually began to understand and take ownership of their medical disease.
I also began to draw simple pictures of procedures before I performed them. Before inserting a scary nasogastric tube into a patient’s nose, I drew an image of what was going to happen. Before placing a foley catheter in a patient’s bladder, I drew a picture of where it was going. Before draining a paronychia on a child’s finger, I drew a picture of what I was going to do. The patients all seemed to tolerate the procedure better when they understood what was happening to them. After a while, I realized that I was drawing the same images over and over again so I decided to compile the most commonly used images into a book. This was the beginning of Diagnosketch.
Here’s an image from 2016, when I first started formally drawing the images by hand with watercolor.
As I continued to draw images, I began to think about different ways to explain things in very simple ways. I would draw a certain image and then test them out on patients to see if they understood. Some images were realistic, others were super cartoony. Through many rounds of feedback, I ultimately settled on the perfect style of image for Diagnosketch. Here are many iterations of images I went through over the years. Some were more realistic; others were very cartoony.
In 2020, I put together a prototype together. I shared it with several contacts at various ERs, Urgent Care Clinics, Outpatient clinics. Because of the overwhelmingly positive feedback, I submitted it for official publication. Please stay tuned for the official book, coming May 2022.
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