Anatomy of a Metaphor

Written by Clara Lu c2017. Photograph via Unsplash

The sea is the land’s edge also.

– T. S. Eliot, The Dry Salvages

Long ago, when our earth was more uncharted than charted, and our anatomy more unknown than known, the explorer and the anatomist carved out parallel arcs to discovery. With expeditions directed inward and outward, they dreamed of intricacy and immensity as microscopes and telescopes revealed atoms and galaxies.

Along with this fascination often came a darker inclination toward ownership: to be the first to publish or the first to plant the flag. Akin were the desires to declare a previously inhabited land one’s colony and to attach individual names to universal anatomy – thus the loop of Henle, the angle of Louis, the Sylvian fissure, and countless others.

For those who denied themselves such eponyms, perhaps ego was overshadowed by humility at the world’s staggering orders of magnitude, both large and small. Pioneers reached for worlds beyond their own, barely describable, with the only words they had. As explorers tacked old names onto new territories – thus Nova Scotia, New Brunswick, Newfoundland – anatomists labeled unfamiliar structures with familiar imagery.

Picture, then, a nomad naming the sella turcica, an architect the labyrinth, a zoologist the cochlea, a geologist the cataract – these our forebears who, among cadavers and against every unknown, held onto their sense of whimsy and wonder. Listen, too, for the auditory imagery amplifying our medical language with resonance and tympany, crescendo-decrescendo, and syncope (the heart offbeat or “syncopated” with the brain).

Can we still imagine anatomy in this way? Although the masters left us little to discover anew, the process of learning anatomy today begins similarly as a vast unknown, inviting creativity. Beyond rostral-caudal and lateral-medial planes, metaphors add colourful new dimensions to our mind’s eye, as both complement to textbook medical illustration and antidote to the formaldehyde of the anatomy lab.

Here, a handful of preliminary suggestions. The corona radiata opens like a folding fan, and the xiphoid process tapers like an arrowhead. Laterally, the circle of Willis is the figurehead, the pons the prow, and the hindbrain the bow on an ancient vessel sailing forth. Undersea, the tricuspid valve closes, rhythmic, like a jellyfish, and the platelet activates like a deranged pufferfish. The imagination is immersed until we no longer see tree roots in coronary arteries but arteries in roots, a film negative.

There is also room for levity. One might rename the scaphoid bone the peanut (as a resident once suggested, for accuracy), or compare a surgeon’s headlight to that of an anglerfish, or nickname the left auricle excision procedure “the Van Gogh.” Not all, but many sights in medicine hold this potential for caricature – a remedy for the usual black humour.

Finally, from the world of music we can imagine, head to toe: the pituitary gland as castanets, hair cells as wind chimes, the oropharynx as a chandeliered concert hall (the tongue a stage, the teeth balconies, the larynx a pit orchestra), the nephron as an inverted treble clef (note the loop of Henle, the juxtaglomerular apparatus), and the duodenum as a backward bass clef (note the major and minor papillae). In a parallel rhythmic universe, we’d call the SA node adagio, the AV node lento.

There’s magic here, and mystery, a beauty with which medicine can imitate life. A stretch of the imagination becomes a stretch of the canvas until anatomy evolves into a world of its own. With creativity, wonder, and a hint of mischief, may we ever be drawn to explore it.

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