Follow Your Curiosity: Humanities in Science and Medicine (TAB #38)

HELEN: Welcome to Talking About Blood. I’m Helen Osborne, host of this podcast series and a member of the Advisory Board for The Blood Project. I also produce and host my own podcast series about health communication, and that’s called Health Literacy Out Loud. Today, I’m talking with Dr. John Chilton, who describes himself this way. I was torn between going to art college or studying a science degree. I chose science and spent 20 rewarding years in research, eventually leading a group studying neuronal development. and lecturing at Peninsula Medical School in the United Kingdom. In 2019, I decided to leave the lab to concentrate on teaching, something I’d always enjoyed and which opened up huge creative possibilities. This resolved the dilemma faced by my younger self, says John. I now have the best of both worlds, finding ways to combine art and science in teaching material, online resources, and absurdly niche cartoons. You can see more of my work at axonology.com. John, welcome to Talking About Blood.

JOHN: Hi Helen. Thank you so much for inviting me. It’s a pleasure.

HELEN: I can already tell you it’s unusual when I introduce guests. It’s usually quite formal, and I try to simplify it a little bit about who they are and their brilliance and all they do. Yours is, in your own words, bringing in humor and humanity. And it is, it’s almost emblematic of all that you do, tell us a little bit more about how you do bring in humor and humanity into the science and medicine.

JOHN: I just think it’s important not to take yourself too seriously. I think it’s important to bring some balance, and I think sometimes that’s lost in academia you can get very focused on very niche areas, highly specialized, and it’s important not to lose sight of why you’re doing that, it’s important to be able to relate to other people, why you’re doing what you’re doing. I mean as a researcher, as a anyone involved in universities, you’re effectively being subsidized by public money so people have rights and know what you’re doing and why you’re doing it and I think if you can bring a little bit of humor to a subject without you know trivializing it, then that helps with communication and ultimately whether it’s teaching, whether it’s public outreach about research, the communication is what’s central to that. And then we all have our different passions and talents and ways of doing that communicating. But fundamentally, that’s what it’s all about. It’s communication.

HELEN: It is about communication. And I do a lot of work in communication, too. But I’ve had the pleasure of looking at a lot of your websites, including Axonology. But our listeners may not have done that. That might be the first introduction to you is what you’re talking about now. You’re one who paints pictures literally. Can you do it abstractly and describe some of the work that you’re doing for our listeners?

JOHN: That always goes through my mind. Nowadays, when you post content on the web, whether it’s a platform like LinkedIn or whether it’s your own website, it’s good practice to put alternative text, recognizing that people may be using screen readers to view your work. Normally I’ve got something that on the face of it maybe is doing a scientific joke or it’s conveying a point I would use in my teaching. But as you said, that’s different than an abstract cartoon. So, trying to think. How do I summarize? I don’t know. Cartoon cell being, I mean, there was one I posted on LinkedIn this morning that’s a platelet being threatened by a snake.

HELEN: Okay. Tell us more about that. Because this really is a challenge and I think it is key to communication. This podcast is audio only. So, we really do have to reach a little bit harder for those words and those images. I know you can do it. Talk about what you just drew or posted today.

JOHN: So, this came from a teaching session that I do about platelets and blood clotting and the sort of drugs that might be used to treat that. As I’ve posted elsewhere, there’s actually a really fascinating episode I know you’ve done on The Blood Project podcast about, the use of snake venom in this area. My way to come at this is always to think right how can I do that in in an image with some level of abstraction and i think it’s about thinking what’s the key point here and to humanize the elements within it. So thinking, right, if I was a platelet cell, what would be my view of what’s going on? And if there was a snake venom present in the bloodstream, how is that going to affect my ability to form a blood clot? And again, on one level… people might say, well, you’re overly trivializing it. Platelets can’t think. What do you mean? But that’s not what it’s about. I’m not always trying to convey some medical or scientific truth. I’m trying to convey a deeper point, a way for people to understand, this is why something like snake venom has informed the development of really important drugs. And here’s a way to understand that visually, to try and portray through a cartoon of a platelet cell being terrified by a snake appearing, to just tell that story in a different ways. A lot of it I think comes down to narratives and just trying to frame it as a story and I think that’s my first aim. And then sometimes the humor comes in, is secondary to that. Some things lend themselves to a joke more easily than others. So I would say at its heart, I’m just using pictures to tell a story.

HELEN: I’m fascinated by doing this because you bring all that credibility as a scientist. I mean, there’s no fooling around on that one. You’re not coming from just someone who liked to draw and you thought blood was a kind of cool topic. You really know what you’re talking about. And I really like how you’re distilling it down. It’s almost you created your own language, your own language of images. You talk about finding the key points of what you want to convey. Indeed, I do that. I did this with you ahead of time of this podcast. I do this with all of them. Like, what are the key points? We could go in many directions. You’re innately doing that with your illustrations, I think, as you’re doing that. You also talk about how you’re bringing in the narrative. I found looking at some of your illustrations, you’re also bringing in the humanity. It’s interesting. I’ve never really looked at a blood cell other than if I’m bleeding a little bit, but I never really looked at that. Many of your illustrations have eyes and have faces. Tell us how you do that without trivializing it.

JOHN: So I always, and I don’t think I do this consciously. In fact, I think about it now. It’s fascinating that you’ve picked up on that. I always start with the eyes when I start drawing a character or a cell.

HELEN: You do?

JOHN: Yeah, absolutely. And that never really dawned on me. But I do that now thinking about it. And because I think the eyes are so central to not just our expression but how we communicate with each other on a subconscious level. And you can convey so much. And for me, drawing the red blood cells, and some of which are now, you know, it’s fantastic to be able to contribute them to The Blood Project as well. But on the face of it, you’re absolutely right. Drawing a red blood cell would be the least attractive cell to draw. It’s just a little round red circle. Where could we go with that? But I found it really interesting to use that starting point and then, so red blood cells can adopt all kinds of fantastic shapes depending on different types of pathology.

HELEN: Tell me what they are. I’m not a scientist. So, describe some of those shapes.

JOHN: So for want of a better word, a normal or a healthy red blood cell is a disc. It’s a bit like if you made a disc of modeling clay and pushed in the middle with your fingers, so it’s slightly indented, it’s slightly concave on each side. And red blood cells have evolved to be this perfect mix. They’re flexible, they can get through the smallest blood vessels, but they’ve also got the right surface area so that they can absorb oxygen optimally. But that system is very sophisticated. They’re very stretchy, but they can’t expand very much. They’re a bit, again, a bit like those sort of stress toys you can get that you squeeze them and it will bulge out in one direction.

HELEN: Oh okay, little squishy balls.

JOHN: Yeah, exactly. So they’re a little bit like that. Depending on everything from maybe environmental insults, so oxidative damage, certain drugs or toxins, genetic changes that will affect the proteins that make up the red cell, all these things can disrupt that structure in, in different ways. Some of them will make those disc shapes just pop out. So the red cell simply becomes like a, like a ball. But there’s other ones where instead of becoming more rounded, more convex, they go the other way. So they become more and more cup shaped.

HELEN: Okay.

JOHN: There’s other ones where they have lots of protrusions. So the cells look like they’re covered in sort of spikes or even small tentacles. And so from a, again, from a cartooning point of view, that was fantastic to be able to, again, exaggerate that and bring life to these characters. One thing that makes me, as you said in the intro, my cartoons are absurdly niche, but it doesn’t pay the mortgage, but I sell my merchandise just because why not? Someone somewhere ordered a whole series of mugs with these different shaped cartoon red cells on them. And I love the idea that somewhere, I don’t know, a hematology department or a research lab, there’s six or seven of them there each with their different crazy different cartoon shaped red cell on there and that makes me so happy to think that someone somewhere has seen the humor in it, but can appreciate it from a professional context as well.

HELEN: Oh, my brain is going in so many different directions. And you absolutely think metaphorically, it sounds like. I don’t know if you think in images, if that’s the first thing that comes to your mind. And you’re shaking your head like, I have the pleasure of seeing you, that you’re thinking that way. The Blood Project is pretty amazing because it really is a labor of love from Dr. Bill Aird, a hematologist, who also really respects all the humanity. And it brings, and I’ve had the joy of using these podcasts to interview people who are talking about blood, who are expressing their interest in blood. Yours through cartooning, someone else through postage stamp collecting, someone else through glass sculptures. I know people are doing it through metaphors and story, images and stories and poems, all kinds of ways of doing that. As a scientist, but also an artist, do you have a sense, is this pretty common that people in the sciences also have the interest in the arts? Or did I just happen upon some really exceptionally neat people?

JOHN: I think there’s probably a fair few people out there who are scientists, but also with an interest in the arts. And I would say the arts in the broadest possible sense. I think the challenge is how you hang on to that in your career. Because you tend to feel that, right, I’m a scientist now, or I’m a doctor, let’s say. My job now is being scientific, it’s being medical. How could I possibly use those humanities? And I think that’s a real shame. And it’s something that I and indeed our medical school, we really try and encourage in our medical students to say, look, embrace the humanities and see what they can bring to you as a person and for your professional development. But also in your interactions with your patients, with the wider public, with colleagues and generally people, you know, if you give them that, that nudge to say, well, think about how you could bring that in, are really excited by that. And I think, again, I’ve been lucky. I’ve been able to find a niche where I can use that. But I think there’s lots of other ways that people should be using the humanities more in so-called ‘scientific’ slash ‘medical careers’.

HELEN: I really like the way you legitimize that, too. I used to work in my clinical days as an occupational therapist. I worked with, you know, medical students or people in their early residency would come to our psychiatric clinic and do their thing. And sometimes I’d ask them, aside from the medicine, what do you like to do? Some of them would just have this blank look. They’ve been working so hard all their lives to get good grades, get into medical school and be where they are now. They let that part of their lives go. I’m thrilled that you found a way to hang on to that and encourage others to do that too. In your teaching, I know that you said, or you and I have talked about how you use different ways of teaching, too, different strategies. These illustrations are part of them. But you approach your teaching, your professional teaching in other ways. Tell us more about that.

JOHN: Yeah, absolutely. I mean, I do use my cartoons in my teaching. I bring, as I say, proper art. So classic. I mean, I love art anyway. So my students, they probably I get an eye roll when I do it now, but I will bring in my favorite Renaissance painters to sometimes to illustrate a point. So for instance, there’s a painting by one of my favorite artists Caravaggio, and in the corner of that painting is a woman who almost certainly has a goiter. So this reflects a thyroid problem. This is something being painted in the 1600s, but it makes the point that hormone disorders have been known about for centuries. So I can use that as an angle to, again, bring a human angle to something that otherwise can feel very sterile and biochemical. Increasingly, I’m trying to use newer digital technologies to bring that in. And again, the red cells are a fantastic example of that because the function of the red cell, as I sort of tried to explain earlier, is intimately linked to their three dimensional structure. So to understand how a red cell works and what disorders might arise, you absolutely need to understand it as a three-dimensional object. But, in medicine, most of the time, you are going to encounter a red cell on a blood smear. So it’s been flattened on a microscope slide.

HELEN: Okay, yes.

JOHN: So in terms of the clinical learning, the students are seeing these things two-dimensional flattened cells, which is totally divorced often from the three-dimensional structure. So using three-dimensional graphics and augmented reality, this is much more accessible now. And again, I developed these three-dimensional digital models. Again, they’re freely available online. I share these and so I can say to the students, I can now have them. I did this in a lecture last week. I had a PowerPoint slide with a rotating three-dimensional model of one of these red cells next to the cartoon of it, next to the technical detail of here’s the genetic change that we’re talking about, here’s the protein change, so that you can actually then link up. This is what the student will encounter in the clinic. This is a cartoon aid memoir, if you like, to help them contextualize it, and here’s an interactive 3D module that will pop up on their phone or their tablet or whatever so that they can really tie together that full understanding. I think that’s exciting in terms of what it opens up in using art in different ways, you’re not necessarily in a corner of, “Oh, I just do cartoons”. It goes back to what you said about how I think in pictures, I think about those visual stories, and it’s just an exciting time with the tools that are available to make that widely accessible now.

HELEN: I’m also relating to that, again, with my health literacy hat, which is not the focus of what we’re talking about, but one of the key points I make is you have to teach in whatever ways people can learn. Some people learn by, you know, all that scientific stuff and the papers and the P-values. Other people through the images, other people through the touching or the kinesthetic experience. It doesn’t matter which way. They’re all equally valid. That’s in my opinion. I think we might agree on that one. Do you ever get pushback on this, either from professionals or people who might scoff at this?

JOHN: Yeah. Again, I’m not trying to claim that what I do will appeal to everybody. I agree entirely with what you said there. For me, what I’m doing is giving a way of understanding something that I hope will resonate with people. I remember once I posted a cartoon online about a bacteria and it was a joke about the bacteria actually being a robot. And I got this quite firm pushback from someone saying, “Well, they don’t actually look like that. How dare you represent my favorite bacteria as a robot?”. And I just thought, I don’t know where to go with this because I wasn’t claiming some deeper scientific truth here. I was clearly making a joke about what if this bacteria was a was a robot. But no, it comes back to trying to find ways to communicate and think. Yeah. I mean, this is something I’ve always been passionate about, scientific outreach. And one of the challenges of that that I think puts off some researchers is it can be very comfortable when you, again, when you work in your specialized area, you talk to all the other specialists, you have all your jargon and you can use all your long words and you’re okay, that’s great. And obviously that requires a certain level of expertise, but can you have that same conversation with someone in a supermarket queue? Can you have that same conversation with a 14-year-old in a school visit, with an eight-year-old at school visit? And I firmly believe that if you properly understand the subjects and if it’s worth communicating, then you should be able to communicate that to a 7-year-old, a 17-year-old, and so on. The challenge comes in, right, what is the important information that they need to understand and how can I convey that in a way that speaks to them? And I’m lucky that cartoons are universal. Children love cartoons and most adults even if it’s in secret. Again that’s the thing honestly in the in the UK, cartoons that are regarded generally as childish, whereas on in the continent places like Belgium and France, cartooning is is seen as the ninth art for. It’s held in a very similar respect to any of the other arts. So I console myself with it is a legitimate way of expressing yourself artistically and there’s some amazing examples that have inspired me.

HELEN: You’re an inspiration to me and I would think that you will be to our listeners. Our listeners, we’ve just kind of put a wrap on this. I hope that they go look at your work. Axonology is one of your sites. You have other sites. I know you’re doing interactive games to be teaching things, how you bring the different media together and hopefully we’ll have that on your talking about blood write-up and transcript there. me Just last words of wisdom or of something you’d like to pass along for our listeners. They may be seasoned professionals, advanced hematologists, someone who’s been doing this work for quite a while. They may be someone newer to the sciences or medicine and just people, everyday people like me, who just want to know about blood. What would you like to leave us with? What message would you like to share?

JOHN: I would say just embrace your passion. If you enjoy art, if you enjoy drawing, just do it. Find a way to bring it in. I do encourage my students. They come to me and say, “Oh, but I’ve seen your drawings and I really wish I could do them”. And I have to say, well, no, those are my drawings. Your drawings will be just as special and you will have your own way of expressing things. A good example is I’ve encouraged the medical students to set up a creative medic society within the medical school, just where they come together with a shared interest in art. I was chatting to one of the students who came along and she was drawing in a little sketchbook. And I said, oh, you know, do you mind sharing that? And what she was doing, she’d just come from a surgical placement and just found it really helpful to to sit and just do little sketches based on what she’d seen in surgery. It helped her process it. It helped her process, you know, what she’d seen the emotions of being part of that. Just using art simply as a personal tool to work through experiences is just as valid as, you know, doing some wacky cartoon that happens to go viral. So I think who, you know, whoever you are just just find a way to to use humanities in what people might say is a scientific. There’s nothing that should be off off limits, I don’t think.

HELEN: Oh John, I’m just so absorbed in all you’re saying, I resonate with this. I thank you, I thank you for all your wonderful work and for sharing it with us on Talking About Blood.

JOHN: Thank you so much for having me. It’s been a lot of fun.

HELEN: As we just heard from John Chilton, it’s important to bring in humanity and humor to all our work, even in science and medicine. To learn more about The Blood Project and explore its many resources for professionals and trainees and patients, go to thebloodproject.com. I invite you to also listen to my other podcast series, and that’s about health communication at healthliteracyoutloud.com. Please help spread the word about this podcast series and The Blood Project. Thank you for listening. Until next time, I’m Helen Osborne.