Computers: Mae West style of medicine: Dr Andrew Bargery illustrates the use of pictures in the consulting room

Dr Andrew Bargery
Thursday 12 August 1993 18:02 EDT

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'WHADDYA want me to do - draw y'a picture?' Delivered with stinging disdain by Mae West this sounded great. But it would be slightly out of place in your doctor's consulting room.

The fact is that patients do not remember half of what their doctors tell them. Distress and anxiety contribute to this amnesia, but it is often just because they do not understand what is being said. If you have never been taught anatomy, you may not know your middle ear from your maxillary sinus, let alone how they work. And if you cannot visualise something, it is much harder to understand and remember.

So pictures help doctors to explain illness to patients. Most still rely on a biro and a bit of paper. A few can produce a few dog-eared line drawings. But now an increasing number of GPs are using desktop computers to show patients full-colour illustrations of how their body works.

Bodyworks is the name of a cheap but suprisingly effective piece of software from a US company called Phoenix Software which provides several hundred on-screen images of body systems. In my practice we use it routinely to make sure that patients understand what we are trying to explain.

A patient with an earache is not simply told they have otitis media and given a prescription. By showing a 'cut-away' view of the ear-lobe, auditory canal and middle ear with its vulnerable connection to the back of the throat, we can explain how the problem has arisen and how it will get better. A smoker with acid reflux can see how the ring of muscle at the entrance to the stomach is relaxed by nicotine and allows acid to surge up into the gullet, producing pain.

All these pictures and many others from the skeletal, digestive, lymphatic, muscular, nervous, endocrine, cardiovascular, reproductive and urinary systems, are accessible at the click of a mouse. Some, such as the flow of blood through the chambers of the heart are animated and others depict change over time, as in the development of the foetus and its passage through the birth canal. There is also a menu of information about 'health topics' from Aids to sports injuries, but this is pretty basic and most British doctors and their patients would probably not find this feature useful.

I know that patients like Bodyworks - because I ask them. Without exception they report that seeing is understanding. Children are fascinated by it and often ask questions which I would never have thought to answer otherwise. It is important to remember this, because from the doctor's point of view, Bodyworks can sometimes seem frustrating precisely because it is only a basic anatomy package.

What it lacks is clinical pathology: images of such common conditions as asthma or acute bronchitis, hiatus hernia, peptic ulceration, coronary artery disease, appendicitis and . . . the list is both obvious and endless. Such a programme might serve as a potent health education weapon. I am quite sure that Bodyworks 2 will appear in due course. In the meantime we must at least be truly grateful for what we have received. Not the least of Bodyworks attractions is that it is comparatively low-priced (under pounds 60). So if you have ever hankered after a guided tour of your own insides . . .

The growth of CD-rom technology is bringing other, much more ambitious and expensive medical graphics to a consulting room near you. If your crusty old family doctor shows suspicious signs of uncertainty when you show him that funny little rash which has been troubling little Gloria, just tell him about Adam and CD-Derma.

Adam - Animated Dissection of Anatomy for Medicine - is said by its authors to be 'the 21st century's equivalent of Gray's Anatomy', a sort of surgical flight simulator. It comprises many thousands of detailed, high-resolution, full-colour illustrations of the entire male and female anatomy - the distaff version is, of course, called Eve - which allows users to dissect their way through 40 separate body layers right down to the bone.

Linked to multimedia facilities like sound and video, it can re-enact entire surgical procedures, display X-rays and CAT scans. But there is a slight snag: it costs more than pounds 2,000 in its full form, although you can carry off just a limb if you prefer.

CD-Derma is also a sign of things to come. Produced by a Belgian company, the first of a planned 14-disk series is already available and should provide an expert and exhaustive survey of skin disease. The authors will then move on to eyes. But it may take some time, so do not watch this space.

Vital Statistics

MEDICAL DIAGNOSTIC SOFTWARE

CD-Derma: Lasion; 010 323 230 1678 (Fax: 230 5536).

Bodyworks: Software Marketing;

1 602 893 2400. (Fax: 893 2042).

Adam: MP; (Tel/fax) 071 435 4995.

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