Patient information on Botox and other similar toxins
After 28 years of practicing plastic surgery, I have lost count of the number of times a patient told me that I am an artist. While I thanked them for the compliment, I could not believe, or accept it. An artist is someone who, from childhood, seems to be able to draw, paint, or sculpt intuitively. Or, in the case of music, a talented prodigy who composes at age five.
While I could agree that plastic surgery requires a significant command of knowledge and some degree of dexterity, I could not see the artistic part. My above-average skills at microsurgery, arguably a talent, prevented me from understanding that my colleagues’ results were just as good as mine. The truth was likely that they practiced more, worked harder, maybe even wanted it more.
But artist? My brother, David, was the artist in our family. From about age three onward, he could draw anything, especially the human form, with near perfect proportion. That was talent, that was art.
Around fifteen years ago, as part of my mid-life-rediscover-myself journey, I decided to sign up for an art class. Being a typical cautious, goal-oriented physician, I signed up for what I thought of as more of a craft than an art. Jewelry making fit with my dexterity skills, my love of geology, and making things. I learned quickly, became more skilled, and began producing items which received compliments. My teacher would say, “Nice work!”. I noticed other artists at the Indianapolis Art Center use the same short sentence. No mention was there of talent.
Later that first year, when a project that I was working on went “wrong”, did not go according to my plan, I planned to scrap it. My teacher, Marilyn Smith, suggested that I relax, and to continue working with the piece. She said, “I sense possibility.” I humored her, continued to try to salvage something out of my plan gone wrong, then noticed that it was doing ok. It turned out differently, but not worse. Over the next few semesters, I learned to trust her, to do as she suggested, and to allow divergence from my plan. She called this, “Collaborating with the medium”.
As my pieces became more advanced and interesting, my plans were more fluid, more open to possibility. Another of my teachers, Kimberly Conrad, talked about humility as an essential ingredient in art. In good work, the artist allows the observer in to participate in perception, with assurance that many interpretations are valid, helpful. I know now, that they were teaching me to find the artist in me.
Six years ago, I decided that I would sign up for a class in an area in which I had no aptitude. I had never been able to draw anything besides stick figures. I had no “talent” for it. However, I was a bit tired, by now, of signing up for things on the basis of my abilities. What if I could pursue something if I just wanted to, without regard for ability, talent? What do most of us say about drawing? “I can’t draw”.
My Art Center drawing teacher, Johnny Mckee, answered all of us when he answered me the first night.” The reason you can’t draw is that you haven’t really tried. In this class, if you try, you will be able to draw within a few days, and to draw recognizable portraits within a few weeks. I will teach you to see without preconceived notions.” All six of us were apprehensive that first class as we saw very accomplished drawings on the walls. “Talent? Talent, for some, can be a hindrance. I’ll take desire and hard work over talent any day.”
Our classes seemed to center around activation of our right brains, the visual, non-verbal wondering side of us. We did this by copying other artist’s drawings upside down, so that our left brains could not verbalize and therefore “iconize” the subjects. We learned to draw while seldom looking at the paper, much more often at the subject, the way a tennis player looks at the ball and not the raquet. These lessons were developed from the book, “ Drawing on the Right side of the Brain” by Betty Edwards. I was shown how to put my left brain at rest just enough to allow my right brain to find its rightful work.
So I guess I’m writing about how I discovered what must have been obvious to at least some of my patients. The connection between what I had learned to become a plastic surgeon and what I was learning to be an artist is perception. I assumed that perception was simply seeing, an intake of visual data. I was too obsessive-compulsive, ignorant-arrogant to accept that it is much more than what we are born with, that it can be taught, practiced, worked at.
A month after my first drawing class was over, I was on vacation in Tuscany. Although it was my second time to visit, I was seeing it differently. Before, I had seen things: buildings, people, trees, foods. Left brain, “Identify, judge, move on.” This time, I was seeing surfaces, textures, nothing in any one color.I was busy drawing every chance I could get. One night, our waiter, Stefano, looked very distinctively Tuscan. In beginner Italian, I asked him if I could draw his face. Not knowing how to say “sometime”, I watched him speak to the owner, then return and sit at the empty table next to us. Lit by flickering yellow candle light, I saw a face as I had never seen a face before. My pencil was dull, but instead of sharpening it, I used the side of the lead to make little connected puffy shadows. A kneaded eraser let me gently remove dark spots where the light was most strong. It took twenty minutes or so. Stefano looked at it, said, “bella”, bowed, and returned to his work.
Back in Indianapolis, there was a call for entries into the Art Center’s student show. I entered my portrait of Stefano, which won “Best of Show” in drawing, prevailing against works in the advanced and professional categories. To some, it may have been a sign of talent, yes. To me, it was the result of conquering my fear of failure, believing that I could learn, then working hard under a teacher’s guidance. It was a process similar to that witnessed in the best of my patients. Believe, listen, and work at it. In fact, I remember telling something like that to my children more than a few times.
Returning to my patients, I began using my newfound perception skills to more deeply understand, and to plan procedures with greater flexibility. This began a period of “collaborating with the medium”, my human art. Long ago, I was taught to correct misshapen or injured parts. I had just learned a larger, right-brained lesson: The Harmony of the Whole.
Johnny McKee, Marilyn Smith, Kimberly Conrad, and Vandra Pentecost became my second wave of plastic surgical instructors. Seeing with newly trained eyes, my diagnostic and surgical skills began to change. I more often took in the whole image of a patient, looking for harmony and disharmony. It became less about matching a patient’s feature to a static ideal. Balance and proportion were now more than words, and the words that I used with patients got us to a deeper understanding. Art instruction taught me how to begin, and, more importantly, when to end an operation. Those of us who have made things with our hands will understand how a good result can quickly be made bad by arrogantly striving for perfection until we wished we had stopped sooner.
Being on the clinical faculty of Indiana University’s Plastic Surgery training program, I was able to have discussions with the residents in training of these concepts that I was learning. Several of them wasted no time in asking me if they could participate in some drawing lessons. Those asking were already working 60 to 80 hour weeks, so they must have been convinced of the lesson’s value already. Johnny Mckee taught the first weekly classes, opening the young surgeons’ eyes the way he had opened my older ones. These surgeons were learning artistic principles as they trained in plastic surgery! What would they be capable of at such a young age? The public often assumes that we plastic surgeons certainly must be trained in sculpture, drawing, art. Unfortunately, there is little time in the years of residency for such classes. At least that is what we instructors had been thinking. My residents began to give me feedback after their classes were over. They had learned to draw portraits, sculpt bodies of models, see harmony and disharmony just as I had. Now they said that their perception of patients was changing as well.
The second year of art classes for the residents was noticed by someone who told National Public Radio’s Sound Medicine weekly program about us. Johnny, the residents, and I were interviewed about the classes and the relationship of art and medicine. (http://soundmedicine.iu.edu/segment/3722/Drawing-with-Doctors) The show was one of the most requested on the NPR’s website in 2014. Since that time, Vandra Pentecost has taken over as the residents’ instructor, adding sculpture to the classes.
Looking back, now, on my happy career as a plastic surgeon, learning to draw was a grand turning point. Bigger and better was watching my residents gain the understanding and benefit of art instruction at an arguably better time in their careers than I could claim. As a child, I had not considered myself artistic, but I did admire artists and love their art. Julia Cameron, author of “The Artist’s Way’ would tell me that my admiration was a little clue that I could be an artist. I did enjoy my art classes in elementary and secondary schools. What I liked most was the challenge and freedom to come up with something that I thought was new. In fact, I think that it was my art classes which taught me to innovate, to invent. They probably taught millions of us in this country to do the same. What if there is a direct link between art instruction and our history, in this country, of invention? Do we imperil our future by teaching math and science so much that it is at the expense of art instruction?
I believe that a willingness to learn, and to work hard at it with a teacher’s guidance can reliably achieve what talent can only occasionally do. In that sense, we are all artists.
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