Are you curious about the artistry and expertise behind the world’s most trusted anatomy atlas? In this exclusive interview, we sit down with Dr. Carlos Machado, the Chief Illustrator of Netter’s Atlas of Human Anatomy.
As the creative mind who continues the legacy of Dr. Frank H. Netter, Dr. Machado’s passion for medical illustration and education has inspired generations of students and healthcare professionals worldwide.
Discover his unique journey and visionary approach. This interview is a must-read for anyone fascinated by the intersection of medicine, art, and innovation.
Elsevier:
You have led the editorial project for the Netter Atlas of Human Anatomy for many years, but when did your passion for anatomy and medical illustration truly begin?
Dr. Carlos Machado:
I’ve been captivated by anatomy since I was very young. I was just six when I held a copy of Dr. Netter’s first illustrated book from 1949 in my lap, and even as a child it left a lasting impression on me. I still treasure a copy of that same edition today!
By the age of eight, I was already drawing the structures of the human body, and by twelve, I began depicting anatomy more scientifically and precisely, thanks to access to medical books and being surrounded by older friends who were studying dentistry.
At 17, I entered medical school and have since combined my medical training with my passion for illustration, creating a personal archive of photos and drawings that I still maintain today.
Elsevier:
Anatomy is a core subject, fundamental to the training of future healthcare professionals. How do you see the future of anatomy as a discipline in medical education?
Dr. Carlos Machado:
I envision a future with more integrated teaching, where technology plays a central role, but without replacing the classical foundations.
Anatomy simply can’t be taught solely through screens; hands-on experience with the human body, dissections, and a three-dimensional understanding of structures are still essential.
The classroom of the future will be more interactive, featuring virtual reality, simulations, and 3D models—but direct experience will keep its place at the heart of sound medical training.
Elsevier:
From pencil and watercolors to today’s most cutting-edge technologies, how has your work evolved with these advances, and what role do you think artificial intelligence will have in the future?
Dr. Carlos Machado:
I don’t use digital tools to create my illustrations. I use them, when needed, to assemble layered illustrations, with each component painted separately and traditionally with brush and ink.
It’s true that digital tools have changed the illustration process a lot. Programs like Photoshop let us speed up the workflow and achieve effects that, in the past, could only be done using techniques like airbrushing.
Artificial intelligence isn’t an active part of my work yet, but it can provide certain resources or references. Still, the creative touch, clinical observation, and attention to detail remain irreplaceable by machines.
AI can offer support, but it can’t replace the human sensitivity needed in scientific illustration. It will only have a future in this field if it can think the way humans do.
The mathematical models used in AI don’t imitate the physiology of thought, reasoning, or human intelligence.
Elsevier:
What value do you think traditional paper atlases like Netter’s still hold in such a digital world?
Dr. Carlos Machado:
Printed atlases remain incredibly valuable. They depict anatomy clearly, accurately, and in a style that makes it easier to understand. Plus, they have an aesthetic that inspires students—a beautiful, vivid, and non-repulsive anatomy. This is key to sparking interest and curiosity.
In a world full of screens, paper offers a more focused and thoughtful study experience.
2D illustrations are still essential. They allow us to emphasize certain aspects, show structures from clinical or surgical viewpoints, and aid memory. Even in a 3D environment, well-made flat views remain an irreplaceable teaching tool.
Remember: animations, videos, virtual reality, and augmented reality are, at their core, sequences of two-dimensional (2D) images!
Elsevier:
You had to take up the torch from Dr. Netter for this atlas project. In doing so, you brought your own style to the illustrations. What differences would you highlight between Netter’s vision of human anatomy and your own?
Dr. Carlos Machado:
Dr. Netter’s style was more streamlined, focusing on the essentials. By contrast, I look for detail. I enjoy exploring the complexity of the structures and playing subtly with the color palette, while always staying anatomically accurate.
For example, over time Netter reduced his color palette; I’ve done the opposite. In dermatology, I’ve used over 18 colors in a single illustration.
Technically, in the first half of his career, Netter used watercolor as his main medium and later switched to casein gouache. I use standard, non-casein gouache mixed with watercolor.
On the other hand, I like to show anatomy from less conventional viewpoints to help students and professionals better understand the space and function of structures. Netter focused mostly on standard views: front, side, top. I prefer to go further, seeking new angles that reflect how a surgeon actually sees these structures.
I also include real-life anatomical variations considered within the range of normal, which I believe is essential. I always aim to remain true to the actual human body, without over-stylizing.
Elsevier:
Your hands and eyes have explored and illustrated the entire human anatomy, a universe in itself. Which anatomical region do you find most fascinating, and which has been the most difficult to illustrate?
Dr. Carlos Machado:
I’m passionate about the head region, especially the infratemporal fossa, due to its structural density: nerves, muscles, vessels, fascia… There’s so much packed into such a small space that every illustration becomes a challenge.
As for the hardest part, definitely the brain. Many regions don’t have obvious visual differences, so we must use color codes to teach structures that, in real life, are not easily distinguishable. Portraying these accurately and in a way that’s easy to understand is a huge challenge.
Elsevier:
Having been both a student and now a teacher, you’ve interacted with various learning strategies. What do you believe are the most effective ways to teach and learn anatomy today?
Dr. Carlos Machado:
The key is a blended approach. Dissection remains crucial, but it should be complemented with digital resources, 3D printed models, simulators, and interactive tools. No single resource should completely replace another. It’s the combination that enables genuine understanding.
Also, connecting anatomy to its clinical application for example, showing how a surgeon uses that knowledge is critical for motivating students.
Elsevier:
What challenges do you see integrating traditional and technological resources in anatomy instruction?
Dr. Carlos Machado:
The biggest challenge is maintaining rigor. Technology is exciting, but it doesn’t always show anatomy with the fidelity you get from high-quality illustrations or real dissections.
As I said, the real opportunity is to blend both worlds; embrace digital resources without abandoning the traditional and using each tool for what it does best.
Elsevier:
How have technologies like 3D, ultrasound, and MRI influenced education and clinical practice in this field?
Dr. Carlos Machado:
These technologies have transformed the way we view human anatomy. Three-dimensional images allow us to better grasp spatial relationships, something tremendously helpful for both students and professionals.
Today, imaging diagnosis depends on precise anatomical interpretation, and these tools enable us to see things that were once invisible or unclear using just dissections or two-dimensional illustrations. For instance, ultrasound remains vitally important in measuring thickness and distance of layers, structures, and organs from the skin’s surface.
Elsevier:
What role will medical imaging play in diagnosis and surgery in the coming years?
Dr. Carlos Machado:
They’ll play an increasingly central role. 2D and 3D visualization is key for surgical planning, especially in minimally invasive procedures. It also supports ongoing medical training. But for these images to be useful, a strong foundation in anatomy is essential without that, technology loses its purpose.
Elsevier:
As we wrap up this interview, given your experience, could you share two pieces of advice for students and health sciences educators: what would you tell them to learn and teach anatomy effectively?
Dr. Carlos Machado:
I’d tell everyone to make the most of all available resources. Don’t choose between print atlases, models, or digital tools, use them all. I’d also urge educators to teach from a clinical perspective, showing how this knowledge applies in real medicine. That sparks students’ interest and gives meaning to studying anatomy.
Elsevier:
And for those considering a career as a medical illustrator, like yourself?
Dr. Carlos Machado:
First, study anatomy in depth, you can’t draw what you don’t understand. Second, practice both traditional and digital techniques. Direct observation, drawing from life, and keen attention to detail are essential. Creativity does matter, but only if it serves scientific accuracy.
Elsevier:
And as a final exercise in imagination, how do you envision the anatomy class of the future?
Dr. Carlos Machado:
I’m convinced it will be much more interactive, immersive, and personalized with virtual reality, simulations, and tools that let students explore the human body in depth. But there will always need to be real-life contact dissection, human models, hands-on experience. Only then can we train truly complete doctors.
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