The surgeon as sculptor

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“All right, let’s move.”

The command breaks the silence, and the novice sculptors wheel their chest-high tripods counter-clockwise, circling the model posed on the stand.

The instruction comes from Morgan Yacoe, a 2011 graduate of the Virginia Commonwealth University School of the Arts’ nationally ranked sculpture program. Her students — plastic surgery residents from the VCU Medical Center — pause to absorb their new perspective on the model before turning again to their clay.

The evening workshop is the brainchild of Yacoe and plastic surgeon Jennifer Rhodes, M.D., director of the Center of Craniofacial Care at the Children’s Hospital of Richmond at VCU.

The pair got to know each other when Yacoe sought a mentorship experience with Rhodes during her junior year at VCU. Then, during Yacoe’s senior year, the two worked together to create a medical sculpture of the Tapia conjoined twins. Known as “model surgery,” it was a valuable tool for preparing the reconstructive plan for the separation surgery.

They have since worked on several projects together, including a medical sculpture of a second set of conjoined twins, and have published a paper on medical sculpture in a peer-reviewed journal.

“Plastic surgery and sculpture have a great deal of crossover,” says Rhodes, who has seen sculpture workshops offered during the American Society of Plastic Surgery’s annual meetings. “Having Morgan willing to provide our division with a class here in Richmond is a fantastic opportunity for us to enrich our resident experience by encouraging them to think creatively, fostering an appreciation of subtle anatomic details and applying their anatomy knowledge in a different way.”

The tools of the trade in a sculpture studio are very different from those in an operating room. Yacoe describes the armature, made of three longs strands of flexible wire, as “the skeleton of our sculpture.” She advises the surgeons to spend time on that skeleton — carefully observing its proportions, lengths and ratios — before they start adding clay to their full-body sculptures.

With needle nose wire-cutters, unmarked steel rods for measuring and a bag of malleable gray clay, the fledgling sculptors listen intently as Yacoe emphasizes the vital 360-degree view that provides a 3-D perspective.

“Your sculpture can look just right from one angle, and then when you shift perspective you see that it’s all wrong,” warns Yacoe.

“Once you have a good handle on the overall body, start to think about the contours within that form. The slope of the abdomen, the contour of back. Take some time to step back from your sculpture. Look at the posture; see if it’s different than the model.”

A sculpture workshop is an opportunity for plastic surgery residents to think creatively and apply their anatomy knowledge in a different way. Amy Kite, M.D., who once was asked to carve an ear out of a bar of soap during a residency interview, says, “I believe part of being a plastic surgeon is to be able to use your creativity and artistic ability to perform reconstructive surgery.”

An afternoon rainstorm pushes the humidity higher in the little brick studio. Fingers pinch and smooth the cool, slippery clay as the surgeons gain confidence.

The face of Brian Le, M.D., reflects his concentration. Now in the fourth year of his plastic surgery residency, he recalls a sculpture class from his VCU undergraduate days. He’s been looking forward to the studio session and admits to an audiovisual bent fostered when he served as the mastermind behind the medical school Class of 2009’s Take-Offs, a much-loved tradition in which fourth-year medical students spoof on their school years, and helped them become the first to be projected onto the Byrd Theater’s big screen.

He found transitioning from a patient care setting to sculpting was not hard at all. “In both settings, we are trained to have a keen eye for detail,” he says. In the wake of the studio session, “I have been telling my professors about the wonderful experience. It made us aware of human body proportions and was a relaxing experience overall.”

While a student in the VCU sculpture program, Yacoe decided to pursue the medical field. In her view, “Plastic surgeons are sculptors.” She noticed her students “were fully aware of the sculptural aspect of their work in plastic surgery. One of the students commented on how plastic surgery is all about shaping the body’s tissues for an aesthetically and functionally improved outcome.”

Many plastic surgeons are drawn to the field because they like to work with their hands. This is true for Lauren Nigro, M.D., who enjoys the sculpture workshop for the same reason. She came to the studio straight from the MCV Campus where she’d finished her shift on the hospital floors.

She expects lessons from the sculpture session may translate back at the hospital. “It provided a helpful reminder to take a step back every few minutes and look at the big picture.”

Under Yacoe’s encouragement, the sculptors start moving their stands when the need hits, rather than when prompted. When she calls, “Time for a break,” the model steps down from the stand, but the trainees keep working.

“The first thing I noticed about the class was how quickly they dove into the assignment and how focused they stayed throughout the class,” says Yacoe. “They vigorously sculpted up until the last second, even after the model had left the stand.”

Based on feedback from the plastic surgery residents, Yacoe is now laying plans for a class that focuses on the head and neck. “I love this idea, and I think this is even more applicable for the residents — many of them work on maxillofacial and craniofacial cases. Nonetheless, I do think it was important to have the initial class in figure sculpting to become familiar with overall proportions of the body and comfortable with the material.”

She was particularly pleased that all her students left the class having sculpted a completed figure — cohesive sculptures with accurate overall proportions. Some of the surgeons were sad to leave their sculptures behind. But they left with pictures of the finished piece and a bit of leftover clay to take home and work with on their own.


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