A keen eye for detailed observation

There is much hype on artificial intelligence (AI) in medicine. And of course, AI can serve as an adjunct tool to solve problems in a faster and standardized way, when we must deal with huge amounts of data and high complexity. Nevertheless, AI is not a substitute for human intelligence and human skills.

In cutaneous surgery and aesthetic medicine, a key to success is the most accurate observation of the patient and his or her medical condition. In contrast, a hasty superficial examination could lead to wrong diagnosis and false decisions and potentially violate patient’s safety.

A keen eye for detailed observation is an essential for a successful medical doctor. It becomes even more important by the progress of technological developments and imaging techniques in modern medicine.

The question is, how to develop this skill? It is not a question of inheritance but experience. Is there a way to improve our observation skills? Can we widen our mind in a joyful manner?

Sometimes in life, it is important to turn around and to look back where we came from.

Let’s have a look on fine arts.

Remembering they were part of medical education in the early years.¹ Art has been used in medical drawings for textbooks and in the preparation of moulages. Recent studies on fine arts in medical education have demonstrated improvement of student’s visual perception skills, empathy, and even personal reflection.² What could be trained by fine arts? The most obvious is visual pattern recognition. This is a key element in diagnosis not only in dermatology.³

A bit more sophisticated is the next step – deep seeing. Deep seeing describes the ability to recognize detailed color and texture of a painting that is not obvious on a first glance. La Peau de la Peinture – the surface of a painting is like a skin. Every surface is a translation of nature, of creation and decay.

In office dermatology, it translates into leaving your position behind the office desk, get a closer look, use a dermoscope, etc. Deep seeing also gains importance in case of teledermatology, where the third dimension is missing, and other imaging technologies.⁴

A crucial part is facial expression. To perceive facial expression and interpret, the message in a portrait painting facilitates empathy and care for patients. In esthetic medicine, it is most helpful to ensure a natural look by facial treatments and to avoid unnatural outcome such as a-mimic face after botulinum toxin injections or overfilling in case of filler injections.⁵

At last, we deal with the pertinent negative. The accurate documentation is important in medical education. In clinical practice, we are often confronted with the situation that something is missing. The visual intelligence is challenged if a painting is showing what is not there in addition to what is there to provide a more accurate picture of what one’s looking at. “Acknowledging the absence of an attribute is a skill unto itself, one that is infrequently practiced before the rigors of medical school. Far from being a talent left solely to the realm of medicine, however, understanding pertinent negatives has broad reaching, functional applications throughout life. In any role, art serves as an excellent tool through which to recognize and articulate what often remains unseen.”⁶ In clinical practice, the methods help to narrow down choices to formulate a correct diagnosis.

Fine arts are a great way to develop a keen eye for detailed observation, and a satisfying one! As Shakespeare wrote in “Antony and Cleopatra:” “Age cannot wither her, nor custom stale her infinite variety.”