Art of the Scalpel: Lessons from French Impressionism to Scientific Innovation

By: Tracey Pu M.D. 

The art of the scalpel extends past the operating room, with its influence on our patients’ lives extending beyond the hours spent underneath the fluorescent lights.. As surgeons, we are entrusted with the honor of healing our patients by our hand, both figuratively and literally. The privilege of saving a life is an art, and surgeons serve as artists in the most complex surgeries ranging from pancreaticoduodenectomies to thoracic aortic dissection repairs. However, in pursuit of scientific perfection, it is often easy for the art of medicine to fall to the wayside. Innovation is often born out of challenges against the status quo, and innovation remains paramount within the dichotomy of art and science. 

For example, amongst the most recognizable artists in the contemporary world are Claude Monet, Edward Degas, and Pierre-Auguste Renoir. The French Impressionists’ pastel impasto and fluid brushstrokes capturing sunlight dancing on water lilies are often recognized by even our youngest counterparts, with decorations often gracing the halls of pre-kindergarten schools. These free flowing brushstrokes are often acknowledged as the height of artistic achievement, with over 4.9 million visitors annually flocking to the Musée d’Orsay and the Musée De l’Orangerie for the artistic pilgrimage to witness Monet’s Water Lilies bathing in natural light.1 

However, at the time of the conception of French Impressionism, the bold tactics emphasizing characterization of light were not widely accepted. In fact, the term “Impressionism” was derived from a derogatory scathing review from art critic, Louis Leroy, for which he wrote that a “wallpaper in its embryonic state is more complete” regarding Monet’s Impression, soleil levant, 1872.2 French Impressionism was, in fact, a direct departure from disillusioned traditional romanticism in art promoted by the Academie des Beaux-Arts, which often drew its premise from academic literature or religious context. Common recurring themes and subject matter of the French Impressionists brought accessibility to the working class, with depictions of everyday life and capturing the ethereal light of landscapes highlighting everyday citizens rather than religious figures with artistic interpretation hinging upon education in biblical folklore. This artistic rebellion challenged the norm of classical art precedence, which had previously made art inaccessible to the working and middle classes. 

Additionally, French Impressionism hinted at technological reform through the new available brightly colored pigments and depictions of newly minted locomotion. The Industrial Revolution allowed for unprecedented global collaboration, with many French Impressionists drawing inspiration from Japanese motifs. Incorporation of Japanese cultural references can be seen in many pieces, such as the overt representation of Japanese patterns and folklore in La Japonaise by Claude Monet to the subtle use of asymmetry and negative space in L’Abstinthe by Edgar Degas.3 Integration of global influences further increases accessibility to diverse audiences, amplifying the outreach of these paintings for decades to come.

A similar parallel can be drawn from these art history lessons to scientific advancement in cancer therapies. With innovation underway, a large gap remains in implementation and research. For example, despite rising cases of pancreatic cancer in the United States in the last decade, overall mortality has stagnated4, suggesting a need for novel therapies and improvement of access of care of our cancer patients. Recent groundbreaking trials in the past year have included pancreatic cancer vaccines5,6 and daraxonrasib, a pan-RAS inhibitor7. However, a pervasive need remains for increasing effective enrollment strategies for modern clinical trials to improve access to these novel therapies, as many marginalized populations are unfortunately systemically excluded in clinical trial accrual.8-12 

How do we promote systemic change at a national scale? Implementation remains a considerable challenge in the modern era, both at the local and national level. Proposed mechanisms of sustainable change have included efforts by national societies such as Association of Women Surgeons, American College of Surgeons, Society of Surgical Oncology, and American Society of Clinical Oncology.13-15 Large national accrediting bodies such as the American College of Surgeons Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC) have demonstrated feasibility of employing new standards in cancer care on a national level, leading to deliverance of novel quality improvement initiatives to both academic and community hospitals while simultaneously improving access to guideline-concordant care to marginalized populations. 16,17

Another suggested mechanism of change has been utilizing legislation and incentives at the state level to increase access to cancer care through public health policy, such as targeting deficit areas identified via social determinants of health.18 For example, the State of California has previously passed the California Cancer Care Equity Act (CCEA) which expanded access to NCI comprehensive cancer centers and provided reimbursement of non-clinical expenses including travel, parking, lodging and loss wages.19 In identification of unmet needs for barriers to receipt of cancer care, optimization of distribution of novel therapies can continue to improve via these legislative efforts. Indicators of social determinants of health can serve as a potential framework to identify targets for public health initiatives. 

Nonetheless, the critical need for innovation and improvement of access to care remains omnipresent. As “artists” in the field of surgery, continuous advancement in research and dissemination of novel therapies to vulnerable populations is paramount. Change may often feel uncomfortable, but we must take a leap of faith to continue progress. Driving incremental change in therapeutics and healthcare delivery may be the first step in creating a more equitable future for our patients. 

Dr. Tracey Pu is currently a general surgery resident at the University of Alabama at Birmingham and an aspiring HPB Surgical Oncologist. Dr. Pu graduated from Wake Forest University with Honors in Biology and Studio Art double major with a Chemistry Minor and completed medical school at Wake Forest School of Medicine. She completed a research fellowship at the National Institutes of Health (NIH)/National Cancer Institute (NCI) in the Surgical Oncology Program (2022-2025), with her research focused on how to leverage patient-derived organoid models to study novel kinase inhibitor therapies at the patient-level for gastroenteropancreatic neuroendocrine tumor liver metastases and the role of NFKB in liver metastasis tumorigenesis. Her research interests additionally include how to leverage health systems and policy for increasing access to cancer treatment and clinical trials. Dr. Pu serves as the RAS-ACS liaison for the Commission on Cancer and is involved in national quality improvement efforts surrounding the BeyondASK initiative, which aimed to increase smoking cessation assistance for all patients with new cancer diagnoses. Outside of the operating room, she enjoys photography, oil painting, and traveling. You can follow her at @TraceyPuMD on X.

References:

1.      Almost 4,915,000 visitors for the Public Establishment of the Musée d’Orsay and the Musée de l’Orangerie in 2025. Accessed 05/22, 2026. https://presse-orsay-orangerie.epmo-musees.fr/almost-4915000-visitors-for-the-public-establishment-of-the-musee-dorsay-and-the-musee-de-lorangerie-in-2025/?lang=eng

2.      Everything you need to know about Impressionism: how a group of rebel artists ‘freed painting’. Accessed 05/20, 2026. https://www.christies.com/en/stories/impressionism-everything-you-need-to-know-f36956dac94a49b6a0f18f253d342cfb

3.      Luo H. JAPONISM IN FRENCH IMPRESSIONISM: TRADITIONAL AESTHETIC ELEMENTS GAINING A NEW LIFE. Brown Art Review2023.

4.      Tan JY, Yeo YH, Ng WL, et al. Pancreatic cancer mortality trends in the United States: how much have we moved the needle? Journal of Gastrointestinal Oncology. 2024;15(4):1789-1795.

5.      Huff AL, Haldar SD, Girgis AA, et al. Mutant KRAS vaccine with dual checkpoint blockade in resected pancreatic cancer: a phase I trial. Nat Commun. Feb 10 2026;17(1):1538. doi:10.1038/s41467-026-68324-4

6.      Sethna Z, Guasp P, Reiche C, et al. RNA neoantigen vaccines prime long-lived CD8(+) T cells in pancreatic cancer. Nature. Mar 2025;639(8056):1042-1051. doi:10.1038/s41586-024-08508-4

7.      Wolpin BM, Park W, Garrido-Laguna I, et al. Daraxonrasib in Previously Treated Advanced <i>RAS</i>-Mutated Pancreatic Cancer. New England Journal of Medicine. 2026;394(18):1790-1802. doi:doi:10.1056/NEJMoa2505783

8.      Pu T, Gustafson A, Luberice K, et al. Underrepresentation of Racial and Ethnic Minorities in Metastatic Colorectal Carcinoma Clinical Trials Within the United States. Ann Surg. Feb 1 2026;283(2):316-325. doi:10.1097/sla.0000000000006500

9.      Andrasik MP, Broder GB, Wallace SE, et al. Increasing Black, Indigenous and People of Color participation in clinical trials through community engagement and recruitment goal establishment. PLOS ONE. 2021;16(10):e0258858. doi:10.1371/journal.pone.0258858

10.    Elshami M, Hue JJ, Hoehn RS, et al. A nationwide analysis of clinical trial participation for common hepato-pancreato-biliary malignancies demonstrates survival advantages for subsets of trial patients but disparities in and infrequency of enrollment. HPB. 2022;24(8):1280-1290. doi:10.1016/j.hpb.2021.12.022

11.    Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. Jama. Jun 9 2004;291(22):2720-6. doi:10.1001/jama.291.22.2720

12.    Snyder RA, Chang GJ. Insurance Status as a Surrogate for Social Determinants of Health in Cancer Clinical Trials. JAMA Network Open. 2020;3(4):e203890-e203890. doi:10.1001/jamanetworkopen.2020.3890

13.    Patel MI, Lopez AM, Blackstock W, et al. Cancer Disparities and Health Equity: A Policy Statement From the American Society of Clinical Oncology. Journal of Clinical Oncology. 2020;38(29):3439-3448. doi:10.1200/jco.20.00642

14.    Chiba A, Möller MG, Cannada L, et al. It Takes a Village—Association of Women Surgeons’ Comprehensive Initiative for Healthy Surgical Families for Practicing Surgeons. JAMA Surgery. 2025;160(9):1012-1017. doi:10.1001/jamasurg.2025.2473

15.    Cortina CS, Molina G, Witt EE, et al. ASO Education and Training: Taking the Next Step in Surgical Oncology Health Disparities Research: Identifying Root Causes and Targets for Actionable Change. Ann Surg Oncol. Jun 2026;33(6):4928-4939. doi:10.1245/s10434-026-19221-z

16.    Chan K, Palis BE, Cotler JH, et al. Association of commission on cancer accreditation with receipt of guideline-concordant care and survival among patients with colon cancer. World J Surg. Jan 2025;49(1):34-45. doi:10.1002/wjs.12391

17.    Pu T, Burris JL, Matulewicz RS, et al. National Quality Improvement Initiative to Increase Smoking Cessation Assistance in Commission on Cancer Programs and National Accreditation Program for Breast Centers. Journal of Clinical Oncology. 0(0):JCO-25-01815. doi:10.1200/jco-25-01815

18.    Pu T, Gustafson A, Coleman KN, et al. Social Vulnerability Predicts State-Level Racial and Ethnic Disparities in Receipt of Treatment for Early-Onset Colorectal Cancer Patients with Metastatic Disease. SPRINGER ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES; 2025:S205-S205.

19.    Diaz A, Loehrer A, Pawlik TM. Expanding Access to High-Quality Cancer Care Through Policy—California Cancer Care Equity Act. JAMA Oncology. 2024;10(1):27-28. doi:10.1001/jamaoncol.2023.5010