Penn State

Sheila G. West - Associate Professor of Biobehavioral Health, Penn State University Park

Book Title: The Netter Collection of Medical Illustrations Volume 5: The Heart

Author: Frank H. Netter, M.D.

Book Description:

Frank H. Netter (19061991) was a physician and artist who devoted his career to producing paintings that conveyed complex concepts in physiology and anatomy. His paintings are vivid and beautiful depictions of the anatomical consequences of disease, and yet they are not sanitized images which remove the individual person (the patient) from the anatomical system under study. Dr. Netter's paintings inspired me to learn more about cardiovascular function and structure, and each painting provides a guided tour of the system under study. Despite the fact that he completed most of his work over 30 years ago, I believe this book will remain valuable for decades to come. Our names for the various tissues and structures may change over time and our knowledge of their function is constantly developing, but human anatomy itself remains constant. A quote from Dr. Netter captures the care with which he designed his paintings to teach complex concepts. He said, "the difficult thing about making medical pictures is not the painting at all but rather the study, the thinking, the planning, the creation of a picture so that it says something. Once I have the picture in mind it is easy to put it on paper.

One painting in particular defines the area of study on which I expect to spend my career. This image (on page 216) is entitled "Interrelated factors reputedly concerned in the etiology of atherosclerosis. Even 30 years ago, Netter laid out a single model that captured all of the currently important elements in designing preventative strategies for reducing cardiovascular disease. His painting goes beyond the usual listing of cardiovascular risk factors that were known at the time (diet, exercise, smoking, etc) and shows that treatment of cardiovascular disease requires sophisticated understanding of the effects of behavior on biology and an understanding of how multiple risk factors interact to result in disease. The important conceptual breakthrough appears at the bottom of the image. He depicts two major mechanisms that are likely to be responsible for the effects of cardiac risk factors on atherogenesis: changes in lipid metabolism and changes in the susceptibility of the artery wall. The emerging field of interventional cardiology, and my own work, is now focused on reducing the susceptibility of the artery wall to the development of plaques. Dr. Netter's work anticipated this critical development in cardiovascular science and I hope that his paintings will continue to inspire generations of scholars interested in biobehavioral factors that influence human health and physiology.

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