How to Catch a Killer

In the biggest murder trial in Indiana's history, a nurse named Orville Lynn Majors Jr. was convicted of killing six people by injecting them with potassium chloride to induce heart attacks. In addition, he was suspected of killing more than 100, mostly elderly, patients in 1994 and 1995 at the former Vermillion County Hospital in Clinton, Indiana.

The dramatic trial that ended with a 360-year prison term involved the work of many people. Two expert witnesses carefully studied patient charts and determined the cause of death for each. Piecing together clues, cardiac electrophysiologist, Eric N. Prystowsky, MD, concluded that potassium chloride injections caused the deaths. Cardiac pathologist Bruce Waller, MD, determined and explained that these deaths were not from other causes.

How can two expert physicians convince a jury about complex medical matters when the jurors have no medical background? On the recommendation of Prystowsky, the Indiana State Police contracted Jane Gilmore, a certified medical illustrator, to work with the physicians and help educate the jurors.

About Medical Illustrators

Gilmore is one of less than 300 certified medical illustrators in the world. Medical illustrators have the ability to visually depict any anatomical body part or body function and any medical concept or procedure.

Medical illustrators need to have a very strong interest in science. According to Gilmore, they should have the ability to render lifelike drawings with photo-realistic draftsmanship. They should also be meticulous and able to focus for long periods of time. Gilmore considers herself an artist at heart, but at work she also has to think as a scientist. She enjoys her job because "it allows me to use both sides of my brain. And I'm always learning new things."

Most medical illustrators enter the field either by earning a degree from a university medical illustration program or by following a course of independent study in both bioscience and art. The final (optional) step is to take the certification exam offered through the Association of Medical Illustrators, which includes a written exam and portfolio review.

Medical illustrators work in both traditional media (pencil, pen and ink, and watercolor) as well as electronic media. Most create initial sketches by hand, after which they may use technology for final images. Gilmore says the main advantage to using a computer is that it is easy to modify the image and build on it with multiple layers, which saves a great deal of time.

Where Medical Illustrators Work and What They Do

Medical illustrators mainly create illustrations for patient, consumer, or physician education. They can specialize in many areas, including color renderings, animations, veterinary medicine, interactive learning CDs, and more. They may work for the military, medical schools, hospitals, pharmaceutical companies, or similar institutions. Many do primarily freelance work for a variety of organizations and journals.

Some medical illustrators work in the forensic field doing facial reconstruction to help identify remains or on age-progression drawings of missing persons. Some specialize in prostheses, for example, crafting artificial eyes, noses, or ears unique to each individual.

For the past 18 years, Gilmore's day job has been at the St. Vincent Indianapolis Hospital. As senior medical illustrator, Gilmore produces educational material for patients and physicians; designs exhibits; illustrates new surgical techniques for teaching; produces illustrations for journal articles; and develops marketing pieces for the hospital's services.

Demand is relatively stable for the profession, and alternate fields are expanding for those who have medical illustration training. For example, the film industry hires medical illustrators to do special effects. For individuals trained in multiple areas, such as graphic design, photography, illustration, and web design, there are growing opportunities.

Technological advancements in imaging have created exciting opportunities. For example, CT scans and MRIs can be used to compile data and build a 3-D rotating object. Minute cellular scans have been made of the human body. Medical illustrators are working on the model so that medical students can learn anatomy by virtual dissection.

Educating a Jury to Catch a Killer

As a consultant on the Orville Lynn Majors Jr. trial, Gilmore worked with the physicians to develop graphic devices that would help simplify concepts for the jury. For instance, they had to teach jurors about how the heart works, how the electrical system causes the heart to keep beating, how EKGs are generated and read, and how excess potassium affects EKGs.

They developed the concept of using a four-room house to demonstrate the four chambers of the heart, then used two staircases to simulate the electrical system. "It was very important that the jury understand these concepts for them to be convinced beyond a shadow of a doubt," says Gilmore. "The electrical impulses occur at a cellular level and can't be shown, but people understand houses and can think on that level." Newspaper reports after the trial stated that the team of expert witnesses "made the difference" in the jury's decision to convict.

Gilmore attended four days of the physicians' testimonies with graphics in tow. She spent 90 hours working on visuals for the case, mostly during the month prior to the trial. Of her experience, Gilmore says, "It was so much fun. I would do it again in a second."

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