Mariann Giles, MD, a physician with The Ohio State University Center for Integrative Health, has a strong interest in integrative oncology — the use of diet and lifestyle modifications along with mind-body practices to optimize health. She meets with breast cancer patients in Ohio State’s Stefanie Spielman Comprehensive Breast Cancer Center, informing them of how diet and lifestyle changes can enhance wellness, improve quality of life and reduce symptoms of disease and side effects of conventional cancer treatments.

When she sits down with a patient, Giles introduces them to their body’s autonomic nervous system (ANS), which controls the things that the body does automatically such as breathing, digesting food and sweating. It is the body's "autopilot system." The ANS has two main parts that work like a team but usually do opposite things: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

The SNS, also known as "fight or flight,” is the part that kicks in when you're scared, stressed or excited. For example, if you're being chased by a bear, your SNS would quicken your heartbeat, help you breathe faster and send more blood to your muscles. It prepares your body to fight or run away.

The PNS, or "rest and digest,” works when you're relaxed and safe. Imagine you're lying on the couch after a big meal. Your PNS would slow down your heartbeat, help you digest food, calm your breathing, conserve your energy and support your immune system and hormone balance. It's all about recovery, relaxation and keeping your body in balance.

As Giles leads the patient through the consultation, she discusses with them how stress, including cancer-related stress, triggers the body’s “fight or flight” response. If the body must always fight for survival, it doesn’t have the energy it needs to effectively rest, digest and support the immune system. But through meditation and other holistic health practices, the patient can develop the tools within themselves to restore a calm and restful state.

Giles requested a visual from the Health Sciences Library’s (HSL) Medical Visuals team to share with patients during these one-on-one consultations. The visual helps show the important aspects of the nervous system and the role of stress on the body. This understanding can hopefully motivate patients to engage in practices which support health.

Like many clinicians, Giles had been turning to the internet for images that would help explain the ANS to patients. Most of the images of the ANS she found online had too much detail and were difficult for a lay audience to understand. These images also weren’t designed to lead patients toward healthy, holistic lifestyle practices. Giles needed a visual aid that was simple, patient-focused and tailored to fit her consultations.

HSL Senior Medical Illustrator Anthony Baker understood that, to persuade a patient, this visual needed to represent them. He chose to show one patient split vertically into two mindsets: the left half in a state of stress (hand on forehead, worried expression), the right half in a state of calm (peaceful expression, hand on abdomen).

The patient’s left side is rendered in red tones with a static-textured background to indicate stress. In contrast, the right side is rendered in blue tones with a softer background to indicate calmness. To ensure that the figure would represent a real person, Baker photographed a model in the two different poses and drew from this reference. These two states of mind are split side to side to reveal the brain and spinal cord with simplified pathways to organs. Text highlights the effects on the body’s systems. Baker drew and designed this illustration by hand entirely in Adobe Illustrator and Photoshop. The phrase, “Take back control of your nervous system,” was chosen to remind the patient that, by practicing the wellness techniques prescribed by Giles, they can engage their PNS and improve their health.

Giles has already begun using the illustration with her patients. “This document has been a great teaching tool in helping to convey my message about the ANS from many different perspectives,” she said. “It provides a lot of detail in a simplistic way that adds clarity without overwhelming the patient. I use it in every patient encounter.”

If you would like to discuss patient-focused visual aids, please email Baker at Anthony.Baker@osumc.edu.