A little over a year ago, David Molho, MD was assembling a video to demonstrate a surgical technique used in total hip arthroplasty. He found that the clearest way to communicate what the surgeon’s viewpoint was drawing the anatomy and surgical steps.
He started to doodle, starting with just black and white sketches using his iPad but quickly found a new passion in drawing what he was trying to communicate. “I just started working with some basic photos of bones and went on from there,” says Molho, now in his fourth year of residency. “I drew overlays for the AAOS (American Academy of Orthopaedic Surgeons) video I was making and it just took off.”
The video --- titled Anatomic Navigation for Acetabular Component Positioning in Total Hip Arthroplasty via the Direct Anterior Approach went on to win an award at the AAOS Ortho Video Theater that year, and Molho found something beyond just a new hobby. The drawing enabled him to study the detailed shapes of a bones and anatomic structures. “I find that the study of creating a painting with low amounts of detail really makes you focus on the critical anatomic features. Using fewer paint strokes makes you focus really on the details of the bones and the osteology and the relationships of structures,” Molho says. I think it is a fascinating way to study anatomy. Things can feel so rushed in our field, and this a time where you can study one anatomic subject for a couple of hours. I learn a lot from it.”
He takes his iPad with him wherever he goes, and between cases he can found adding to the latest drawing he was working on. He says his artwork is a hobby, but each new painting presents a challenge in work and approach. The painting highlights new ways of looking at a surgery and anatomy, Molho says.
It helps me learn anatomy more deeply and actively. For example, the femur is manipulated during steps of a total hip replacement; drawing it in different rotational positions helps me grasp the dynamic relationship between structures. Creating a surgical drawing helps me understand all the structures that I'm looking at in the OR for sure because it's such a deep and slow and thoughtful way to interact with the anatomy.
David Molho, MD, PGY-4
“It helps me learn anatomy more deeply and actively,” Molho says. “For example, the femur is manipulated during steps of a total hip replacement; drawing it in different rotational positions helps me grasp the dynamic relationship between structures. Creating a surgical drawing helps me understand all the structures that I'm looking at in the OR for sure because it's such a deep and slow and thoughtful way to interact with the anatomy.”
Medical drawing is often more about seeing the subject rather than creating an artistic representation, said Anne Marie Boustani, MD, an assistant professor in the Department of Radiology and Biomedical Imaging who has a master’s degree in Medical and biological Illustration from Johns Hopkins University. “In order to draw convincing images you have to draw things as they are and not how you ‘think’ they are,” Boustani says. “The moment you start making assumptions, then you lose accuracy, or ‘truth,’ and go wrong. That's the kind of mindset I try to have whenever I'm making decisions as a radiologist and in my daily life as a parent, friend, co worker. It's always about taking a step back, being honest and asking oneself ‘Is this what I think it is? Is it something different? Or, really nothing at all?’ and then readjusting.”
For Molho, it’s a hobby that is turning into something more. He has been posting his art on his website www.TotalHipKnee.com. He has created drawings for several journal articles, an upcoming textbook chapter, and a second AAOS OVT submission.