Pictures at an Examination

SEATED BODHISATTVA (circa 530)

Chinese, Eastern Wei dynasty

In one museum session of the Harvard course, students focus on form, examining the broad, solid base and long, thin fingers of this sculpture of a bodhisattva—a Buddhist figure who strives to attain enlightenment. Back in the classroom, Robert Brown, co-director of the Respiratory Acute Care Unit at Massachusetts General Hospital, discusses factors that control normal movement of the respiratory system. He asks students to watch three patients as they breathe and speak, then to make inferences about what’s wrong. “When one patient takes a breath, the upper part of his rib cage moves inward, not outward,” Brown says, while the very small breaths of a second patient expand her chest almost imperceptibly. The third patient’s cheeks pouch outward with every breath. Thanks to their heightened awareness of form and function, most students come to the correct diagnoses: The muscles between the first patient’s ribs are paralyzed (owing to a neck injury), and the second has a distorted spine that’s wound as tightly as a stiff spring. Because of an inherited muscle disorder, all the breathing muscles of the third patient are paralyzed, requiring her to use a positive-pressure respirator (hidden during the examination).

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