…and you could easily say that Alissa Eckert (MSMI ‘06) is the most famous medical illustrator in the world. Not only has her iconic image of the coronavirus captured the world’s imagination, but the media’s hunger for any COVID-19-related news has made her a celebrity.
She’s been interviewed by the New York Times and the Chicago Tribune. Pieces about the image’s creation have appeared in Popular Mechanics and in papers and on news programs and websites across the globe.
The image itself made the cover of a Time special edition.
“A news station out of Texas wanted me to Skype in,” Eckert jokes. “But I said no — behind the scenes is good for me.”
Behind the scenes is pretty much standard operating procedure in her line of work. Medical illustrators are almost exclusively behind the scenes kind of folks, highly skilled professionals who create the images used in textbooks, instructional material, public health campaigns and by the media, but they almost never earn any personal attention for their work.
But just as the bristly novel coronavirus changed pretty much everything else on the planet, it changed this arrangement, too. Almost overnight, the image she and Dan Higgins, her partner at the Centers for Disease Control and Prevention (CDC), created became the face of our global enemy, and because of it, Eckert became the face — or at least the identified presence behind the curtain — of medical illustration.
“I have friends over in the Netherlands, and they started sending me pictures when it started popping up on their local news,” she says. “People from different countries are contacting me — from Canada, from Norway. It’s all over the place.”
While no one could have predicted the degree to which the image has engaged the world and symbolized its dread, that’s actually exactly what she designed it to do. Though it has enough scientific accuracy behind it to be valuable to scientists, the image was created to provoke just this kind of emotional reaction from the general public.
On Jan. 21, Eckert’s bosses at the CDC asked her to create a visual identity for the virus, a so-called beauty shot that would be the cornerstone for the branding and information that would follow as part of the CDC’s response. To accomplish that, her picture would have to be worth at least a thousand words, but how the picture conjured those words — that would be up to her.
As a coronavirus, it has a particular array of proteins — spike proteins (S-proteins), envelope proteins (E-proteins) and membrane proteins (M-proteins). While their structures are accurately modeled from the protein database, the choices of colors and texture and presentation are all part of how Eckert chose to display them. The S-proteins she made red, the E-proteins yellow and the M-proteins orange. If you look closely, the S-proteins even cast a menacing shadow across the rest of the virus.
Eckert told the New York Times that after trying a variety of different color combinations, she found red on grey accentuated by orange and yellow to be the most arresting.
“The image was really designed to engender understanding of an idea of what this thing is for the uninitiated,” says Bill Andrews, chair of Augusta University’s medical illustration program, which is part of the College of Allied Health Sciences. “I’ve seen other versions of the coronavirus, and some of them look kind of cute, like a Saturday morning cartoon with a springtime pallet of pinks and soft blues and yellows. And that’s all well and good, but when I look at the one Alissa did, it seems scientific and business-like, but at the same time, there’s this overt danger implied by the use of red and yellow.”
According to Andrews, that’s part of the modern medical illustrator’s job. From roughly the Renaissance through the early 1900s, the job was about documentation, but with the advent of photography and things like x-rays that could record images outside the visual spectrum, the job moved more toward interpretation.
“As medical illustrators, we’re always trying to tell somebody else’s story,” Andrews says. “In this case, it was the CDC’s. And whether or not we’re good at our jobs depends on whether the audience actually gets the story the way the client was hoping. I would say in this case, Alissa’s hit it out of the park.”
That success, he says, is directly attributable to the choices she made.
“Everything that goes into that illustration required a choice,” he says. “Some of them are instinctual, based on your skills and experiences, and some of them are consciously made. I like what she said [to the New York Times] about using the reds and yellows to actually heighten the sense of peril or drama in the piece.”
As a beauty shot, it has to do a lot at once glance, as opposed to an illustration that communicates behavior. To do that — and to remain scientifically accurate — Eckert used a sophisticated program called Autodesk 3ds Max, which allowed her to take different parts and assemble them into one image.
“Using some of the depth of field that we used and the lighting helped our communication by adding a sense of realism,” Eckert says. “The step-by-step process of getting all these parts into the computer was easier than to try to hand draw it.”
Given the urgency, it was a quick turnaround, too — about a week from start to finish.
As part of the CDC’s Communications Division, Eckert provides support for all of the different agencies at the CDC.
“It can be for anybody that puts in a request needing communication needs,” she says. “It might be for the public, it might be for a scientific journal for one of the scientists.”
The CDC covers a lot of ground, she says, from special pathogens and cancer and flu to injury and AIDS and everything in between.
“I could be working on a virus one day and the next I could be working on a birth defect or an image of a throat or the life cycle of a flea,” she says. “It’s all over the place.”
That versatility is part of what the interpreting role demands — and therefore, central to what the medical illustration department trains them to do.
“It’s what flows through every assignment,” Andrews says. “What do you know about the audience? What do they know already? What do they need to know? What do you want them to be able to do after seeing your illustration or animation?”
It’s a daily conversation with the students, he says. And as a result, they develop into better critical thinkers, better problem solvers and better visual communicators.
Part of that comes from scholastic, scholarly research — what others have found to be true — but part of it comes from teaching the students to be self-reliant.
“It’s about training them to the point where they do this well enough, they do it long enough and they think deeply enough that they develop really good, strong instincts about what’s going to work and what may not work so well,” Andrews says.
In other words, exactly the kind of thinking that helped Eckert create the coronavirus image.
Augusta University’s medical illustration program is the oldest graduate medical illustration program in the country and the oldest continuously accredited graduate program in the world. One of only three in the nation, Augusta University is highly selective, capping acceptance at only nine students per class.
“We look for students who have really mature, artistic aptitude and talent as well as a real insatiable curiosity in science — those who really need to know how and why things work,” Andrews says.
Because of that, they’ll accept — and have accepted — students from almost any undergraduate background. They’ve also had students enroll from every state accept Alaska and Hawaii, and from several other countries.
“I think it’s a testament to our ability to recognize talent and recognize students who are ready to grow in our field and not have to be very specific about looking at a particular undergraduate degree or even a particular GPA,” Andrews says. “It’s about finding the right person who has that drive to create images that help explain complex medical stories.”
Students in the two year program are fully integrated into the medical gross anatomy courses and neurology and pathology courses taken by med students at the Medical College of Georgia.
“They’re studying right alongside the medical students,” Andrews says. “The one exception to that, although it is still literally alongside, is in the cadaver lab, where our students have their own cadavers that they share — a male and female.”
Linden Pederson is finishing up her first year in the program, cramming all the artistic learning in with all the medical learning. Like Eckert, she came from the University of Georgia’s scientific illustration program, so she was already familiar with many of the software programs used on the illustration side. While she always knew she wanted to do something science-related, she says she’s thankful to have found something that so uniquely includes her love of art as well.
While it might seem unusual to have such accomplished artistic abilities integrated so seamlessly with scientific abilities, Pederson says it would be wrong to think of the two sides battling each other, as people often do. For her, the two disparate things complement each other.
“Sometimes, one can be a nice relief for the other,” she says. “A good break for studying the science aspect is working on art projects, and sometimes you just need to step back from an art project and come back at it with fresh eyes, so going and working on science for a bit utilizes a different part of your brain.”
Seeing the human body and the science of life up close — and understanding it — is important, she says, and part of why she values the education provided by the department.
“They really do place value on learning the science aspect of it,” she says. “Maybe for some art-brained people it’s not exactly intuitive, but I think it’s definitely something important that we all kind of tune into, because we know what we’re illustrating is correct, and for our field, it definitely matters. It has to be done very precisely or else you’re giving people incorrect information.”
For Ben Brown, who is currently finishing up the program and looking toward graduation, the amount of information he and his classmates are absorbing is staggering — and he knows a little something about absorbing information. He was an MD/PhD student at Virginia Commonwealth University for a couple of years before taking a leave of absence and joining the Peace Corps as a public health acquisitionist in the Dominican Republic. A lot of the medical training he’s receiving now is review, which he says has helped him catch up with the art side of things. Though he’s always loved art, prior to coming to Augusta, he’d never had a formal art class.
“I wasn’t sure what I was expecting, but I’ve accomplished so much more in the past two years than I ever thought I could accomplish from an art perspective,” he says. “I just shocked myself at being able to pull off some of the things that they pushed us to do.”
That sense of accomplishment is something Eckert continues to remember as well.
“There was so much compacted into such a short period of time, it was amazing that we were able to accomplish as much as we did,” she says. “Interacting with the med students was interesting, and the interactions we had with physicians and the projects we did with the dental school and occupational therapy and the different people around campus — the real world experiences we got to experience with all these different professionals out there — was tremendous.”
According to Andrews, the program’s demands frequently astound educators on the outside as well.
“Sometimes, we have to explain that for every assignment, there are two content areas the students have to master: one is the scientific information, because there’s always an anatomical, pathological, histological or surgical subject for the assignment; then, there is always some graphic technique or media type that they’re having to learn about and master as well,” he says. “We’ve had people look at us and go, ‘You can’t do that,’ and we’re like, ‘Why not? We’ve been doing it for 70 years.’”
All find the unprecedented exposure Eckert’s image is bringing to their profession inspiring. For Brown, who says he was drawn to medical illustration in part because of the opportunities it gives to the entrepreneurial-minded — he’d eventually like to open his own animation studio — the exposure underscores the importance of tailoring your skills to the subject matter in the way demanded by the audience.
“That’s where the mastery comes in,” he says. “Seeing someone like Ms. Eckert, who’s pulled off executing a piece that is perfect for the target audience, shows us that there is the opportunity for something you do to be considered great work, not just by the people who hired you to do it or for the target demographic. It could conceivably be picked up all over the world.”
Pederson was also excited about how the notoriety could help educate people about the field.
“I know all of us have been bragging to our family members and telling them the person who created that image graduated from our program,” she says. “When I tell people I’m going to school for medical illustration, sometimes they go, ‘What’s that?’ and it’s hard not to repeat those same exact words back to them, because that’s kind of what it is: medical illustration.”
Even though the program is capped at nine students per class, Andrews hopes the notoriety increases the number of applicants so they can continue to find those perfect matches.
As for Eckert, she hopes it sparks awareness in medical illustration as a career and as an educational opportunity.
“It definitely would have made life easier for me if I’d have known in high school about this,” she says. “A friend of mine that I work with knew it’s what she wanted to do in eighth grade, and I’m like, ‘Man — you’re so lucky you knew your path early,’ because I ended up with an extra year in college and 170 credits when I graduated.”
As Eckert’s notoriety was ramping up, in-person classes were dialing back at Augusta University, moving totally online by March 30. According to Andrews, the change was a little awkward and time consuming, but they made the adjustment fairly easily.
“It’s not the most efficient way of doing it, but like medical illustration in general, we’re about solving problems and telling stories, so we’re making it work for us,” he says.
For Brown, who’s wrapping up his education in uncertain times no one could have predicted, that response has been appreciated.
“For us to be able to continue our education in this climate and feel as though we’re still absorbing the knowledge that we need to continue our education toward graduation — or, for the juniors, toward the next step — is really gratifying,” he says. “Between the technology and the resources we have, our department is really motivated to continue to give us the best experience.”
At Alumni Weekend 2021, the medical illustration program will celebrate the 70th anniversary of its first graduate, Robert Benassi.
“Bob Benassi went on to work for the Mayo Clinic for a long time and eventually won the Lifetime Achievement Award from the Association of Medical Illustrators,” Andrews says. “Our departmental alumni award is now named after him.”
Andrews says that the medical illustration program has some of the most engaged alumni at the university, and while the uncertainty of traveling for some of the older alumni was initially discouraging, Andrews hopes the new prevalence of virtual communication platforms will actually make alumni participation in the event even greater.
Along with the opportunity for meeting old friends and sharing history, Andrews hopes to brief alumni on opportunities to financially support the department and its students. In addition, he says alumni of the program should keep their eyes open for a call for hairy nevus submissions.
The hairy nevus drawings (nevus is another word for mole) were a rite of passage for medical illustration students until the mid-1970s, and Andrews is toying with the idea of creating a special gallery to honor this unusual bit of program history.