The hand of Aris Kindt
In his book The Rings of Saturn, W. G. Sebald points to a distortion in Rembrandt’s oil painting The Anatomy Lesson of Dr. Nicolaes Tulp that I cannot unsee anymore. As we know, the 1632 painting portrays the public postmortem examination of the body of Adriaan Adriaanszoon (alias Aris Kindt), who was found guilty of armed theft and hanged only a few hours before the performative dissection. Dr. Tulp’s lesson took place in the Waag (‘weigh house’) in Amsterdam, and was a significant event of the time, not only for surgeons but also for the rest of a society that was ready to be awed by modern science. The paid spectacle, offered before an upper-class audience (surgeons are well dressed, Dr. Tulp wears a hat) was a demonstration of the quest for knowledge and progress. Rembrandt depicts the scene with astounding realism. Aris Kindt’s greenish, rigid body lies with a broken neck and a bulged chest. None of the surgeons looks at the body as such. Rather, they lean over it, almost touching it, to fix their eyes on the dissected left hand. This hand, in contrast to the rest of the painting, seems withdrawn from an anatomy textbook; it is almost educational, a mere illustration of muscles, bones and ligaments. Sebald observes that, from an anatomic point of view, Rembrandt’s depiction of the hand is incorrect. The visible tendons which, according to the location of the thumb, should correspond to the left hand palm, are in fact the tendons of the back of a right hand. Rembrandt’s composition, otherwise executed with admirable mastery, is spoiled precisely in the most important place. The flipped hand of Aris Kindt. This is the distortion I cannot unsee anymore.
It is quite impossible that Rembrandt got it wrong. Sebald goes on to argue that the artist, via this grotesque, sketchy hand, is signalling the violence exerted on the criminal’s body, the unnecessary punishment beyond death. The artist puts himself at the level of the victim, not of the surgeons that commissioned the work. I suppose that Sebald is right in his reading of the artwork. I am not trained to have an opinion of my own, but what is clear to me is that there are at least two views of the autopsy scene. The view of Dr. Tulp (which is the view of an enlightened society) and the view of Rembrandt, who is the only one that cares about the untouched body (the soul and the fate) of Aris Kindt. Note the deadly shadow on his mouth and eyes.
It seems that René Descartes (an amateur anatomist himself) was there in the Waag that morning. Descartes saw the human body (and any other entity of the natural world, for that matter) as a working machine that can be understood fully, something that can be controlled and repaired. To this day, scientific practice has been rooted in the cartesian approach and, I must say, I don’t believe there is a better alternative. Especially in the biomedical sciences, where the subject of study (a diseased human body) is very complex, you can only do your best to break the system into elementary parts that can be examined in isolation, and then assemble them back together in the form of diagrams and atlases. So I am not trying to denounce anything or raise criticism by exposing the case of Aris Kindt (and I am not a philosopher of science, anyway). However, the risk that Rembrandt took by flipping that left hand, ruining the realism of his painting, kept me thinking for a while. As a data scientist, I am easily fascinated by the release of novel datasets, and I often welcome them in a celebratory mood, more so if they come directly from hospitals. A non-exhaustive list of such datasets that I’ve used recently includes GTEx (a biobank of healthy tissue samples corresponding to nearly 1,000 individuals who died in an accident), TCGA (2.5 petabytes of cancer genomics data points from 20,000 primary tumours), TB Portals (over 6,000 tuberculosis cases, including 8,000 chest X-Ray and CT images, some of them accessible with a fantastic 3D viewer), CHAMPS (from a consortium that operates in countries like Bangladesh, Ethiopia, Mali or Mozambique, and gathers child mortality events and associated causes of death, including preventable infections and malnutrition), the ClinicalTrials.gov website (an archive of more than 400,000 clinical intervention studies), and of course the corpus of COVID-19 articles, that only one year into the pandemic amassed half a million instances. I lost count.
I think it is fair to say that I approached each of the datasets above with the same mindset as any of the surgeons that lean over the body of Aris Kindt. Once in the computer, data becomes a puzzle that needs to be solved. Its societal meaning quickly vanishes in front of statistics and plots. This always happens, inevitably. It happened to me even after I collected, personally and on a USB stick, 180,000 medical records from a dozen clinics in Lusaka (Zambia) related to women screened for cervical cancer and HIV. I remember that day vividly. I was the disoriented, overwhelmed and absurdly enchanted European that you are imagining. My friend at CIDRZ (a 20-year old nonprofit that has grown to be the most important laboratory of the country) drove me clinic by clinic, inexplicably skillful at the wheel given his young age. In some clinics there was no electricity, so we had to wait until power came back. In others there was a queue for the testing room, so we had to wait for our turn, sitting next to the women that were about to be examined. I don’t think that, as a computational person, you can get any closer to the data than this. And yet, it always happens that the meaning of it vanishes. I was lucky, in this case, to have my dear colleagues Albert Manaysan, Kati Taghavi and Jake Pry, who always had a word of concern every time I came to them with a new exciting discovery. ‘Women living with HIV are more likely to test positive for cervical cancer’, I would say, ‘there is a peak in the trend for younger women’, ‘many positive cases are not followed up’, et cetera. I am deeply grateful for those discussions with Albert, Kati and Jake. It is thanks to their words of concern (to their Rembrandt’s point of view, I may say) that this study in Zambia is a special episode in my life and career.
