Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Members & Subscribers
    • Benefits for CMA Members
    • CPD Credits for Members
    • Subscribe to CMAJ Print
    • Subscription Prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Commentary

Launching a new journal page: Clinical Vistas

Eric Wooltorton
CMAJ October 30, 2001 165 (9) 1221-1222;
Eric Wooltorton
Dr. Wooltorton is 's Editorial Fellow for 2001–2002.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

You cannot experience your own interior by closing your eyes and concentrating on it. In order to discover your own contents you have to investigate the inside of someone else.

— Jonathan Miller1

Human beings have always speculated about their physical contents; the difficulty has been in obtaining an adequate interior view. Although human dissection (of criminals, whether dead or alive) was permitted in Alexandria in 300 BC, Galen, 5 centuries later, still had to extrapolate human structures from animal parts.2 Impeded by law, moral scruples and dogma, the study of the human anatomy progressed by fits and starts, always in tandem with the artistic representation, on paper, in woodcut, engraving or wax model, of what was seen at times with questionable objectivity. With the 19th century came new technologies that offered not only new ways to record, but new ways to see.

Roentgen's discovery of x-rays in 1895 offered views of anatomy and pathology that would otherwise not be felt, seen or heard in a living person. Now we have even more wondrous means of peering into the human frame. With fibreoptic scopes we look down throats, and into knees, stomachs, bowels and bladders from new angles. Computed tomography and magnetic resonance imagery give us virtual “slices” of life. We inject nuclear isotopes and scan bones, glands, brains, hearts and lungs for defects. Diseased tissues declare themselves through special dyes and tags under microscopes that are increasingly powerful. With ultrasonography we record echoes of our present, and promises of the future. We can identify currents, chemicals and chromosomes, and we can even track a sperm and egg intermingling at the start of something big. Although we will always rely on our patients to describe that domain of self that is personal (felt), a host of technologies have now expanded what can become public (seen).

Every day, physicians are presented with clinical situations that can be dramatic, poignant, fascinating, beautiful, classic or rare. In the words of physician and Pulitzer Prize–winning poet William Carlos Williams “whole lives are spent in the tremendous affairs of daily events without even approaching the great sights that I see every day”.3 Aspects of these sights are often captured in photographs, radiographs, micrographs and scans. Medical imaging usually has practical intentions; “it is meant to be evidential, not interpretative. One takes photographs of a case (as distinct from a person) to act as teaching aids, as demonstration of a diagnosis, as a record of the progress of treatment or the process of disease, as legal record, as forensic evidence. The clinical photograph is perhaps the furthest that photography can get from art.”4 It is easy to lose the perspective that the images that we encounter every day are remarkable, not to mention beautiful.

From the earliest days of medical school, we learn to put aside personal and societal taboos about probing into the bodies and the stories of others. Paradoxically, the very technology that is meant to allow us to see deeper into human beings than ever before allows us to keep our distance, both physically and emotionally. Just as Laennec's stethoscope allowed a physical and metaphorical remoteness to evolve between physician and patient,5 sophisticated technologies allow us to diagnose at a distance, sometimes without ever having seen the patient. Focusing on the clinical details, it is easy to lose a sense of wonder about the particular aspect of the human condition that medical images reflect.

At CMAJ, we are proposing a new journal page to start in 2002 that will use visual cues for review and reflection. We plan to combine 2 or 3 interesting images on related themes, with figure legends that briefly explain what is seen or the cases involved. Surrounding the images will be snippets of text written by our editorial staff that summarize some interesting aspects of the recent literature about the topic raised in the images.

Our main goal is to allow physicians to share with one another some of the views of “the human condition” that they have captured in clinical images. A secondary goal is to help physicians to close the gap between themselves and their patients, and to rekindle the sense of wonder and fascination that may have inspired them the first time they saw such images. We will consider nearly any sort of image — photograph, scan, radiograph or micrograph, whether common, classic or rare — that is in some way visually interesting. A big, bright red eardrum may prove as stunning as a high-resolution MRI of a rare fascinoma. The images need not be from a conventional clinical setting; an outreach worker's photo of a heroin addict injecting into a vein may find itself in the journal next to a chest radiograph of Pneumocystis carinii pneumonia. A photo of the stooped posture of a patient with parkinsonism, snapped during a home visit with all the collateral visual context, could prove more meaningful than a similar photo posed in front of a white screen in an office.

A few firm requirements exist. First, like all other submissions to CMAJ, the material must be original. Second, consent for the image to be published in the print and online versions of the journal must be obtained from the patient and documented. Third, the image must be sharp, with clearly visible details. Fourth, the image must come from a clinical encounter, even if the encounter is in a nontraditional setting. Images can be sent to us by post (Editorial Fellow, CMAJ, 1867 Alta Vista Dr., Ottawa ON K1G 3Y6) and inquiries about possible submissions may be directed via post or email (eric.wooltorton@cma.ca).

The word “vista” can mean both a “long narrow view as between rows of trees” and “a prospect or panorama.”6 In our Clinical Vistas page we hope to foster a double focus: examining detail, but embracing context.

Figure

Figure. “Abdominal Muscles” by Jacopo Berengario da Carpi (1521): anatomical depictions such as this print from a woodcut are subject to obvious artistic interpretation. Although modern imaging techniques are arguably more objective, they capture fascinating, but imperfect, views of sickness and health. Photo by: National Library of Medicine

Figure

Figure. MRI: a remarkable slice of life.

Figure

Figure. Arthroscopic view of a torn meniscus: such glimpses inside a joint are among the most common orthopedic procedures, and yet are foreign to many physicians in other medical fields.

Photo by: Courtesy of Dr. Bill Smyth

Footnotes

  • Competing interests: None declared.

References

  1. 1.↵
    Miller J. The body in question. Rugby (UK): Jolly & Barber Ltd; 1978. p. 41.
  2. 2.↵
    Duffin J. History of medicine. A scandalously short introduction. Toronto: University of Toronto Press Inc; 1999. p. 14.
  3. 3.↵
    Williams WC. The practice. In: The autobiography of William Carlos Williams. New York: New Directions; 1967.
  4. 4.↵
    Todkill AM. Boundary crossing: the physician and the photographer. CMAJ 2001:165(1):35-6. Available: www.cma.ca/cmaj/vol-165/issue-1/0035.asp
  5. 5.↵
    Duffin J. To see with a better eye. A life of R.T.H. Laennec. Princeton (NJ): Princeton University Press; 1998.
  6. 6.↵
    Barber K, editor. The Canadian Oxford dictionary. Don Mills (ON): Oxford University Press; 1998.
PreviousNext
Back to top

In this issue

CMAJ
Vol. 165, Issue 9
30 Oct 2001
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Launching a new journal page: Clinical Vistas
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Launching a new journal page: Clinical Vistas
Eric Wooltorton
CMAJ Oct 2001, 165 (9) 1221-1222;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Launching a new journal page: Clinical Vistas
Eric Wooltorton
CMAJ Oct 2001, 165 (9) 1221-1222;
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Send us your briefs! -- a new CMAJ call for medical images
  • A call for video images: medicine in real time
  • CMAJ: What's in it for you
  • Le JAMC : Ce qu'il peut vous offrir
  • Google Scholar

More in this TOC Section

  • Ensuring timely genetic diagnosis in adults
  • The case for improving the detection and treatment of obstructive sleep apnea following stroke
  • Laser devices for vaginal rejuvenation: effectiveness, regulation and marketing
Show more Commentary

Similar Articles

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire