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Artist’s Statement


Svrakic, Maja, MD, MSEd

doi: 10.1097/ACM.0000000000002504
Cover Art

M. Svrakic is an assistant professor of otolaryngology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York; e-mail:

Approximately 10% of couples trying to conceive in industrialized countries do so with the help of in vitro fertilization (IVF).1 In the United States this amounted to about 186,000 cycles of IVF in 2015 alone, out of which only about a third resulted in live births.2

As a patient undergoing IVF, whose infertility is due to a yet-undiscovered cause (officially, the “unknown factor”), I am attempting to let go of overanalyzing, controlling, and rationalizing. This is an arduous task for a surgeon like me. While the psychological stress a woman experiences through this process is well documented,1 her coping mechanisms are not. Visual art has allowed me to process the complexity of my ever-changing emotions as they relate to infertility.

I painted Primordium, on the cover of this issue, to conjure the deep, dark sea; the last unknown. Here, death can be tumultuous and silent at once, and I am reminded of this duality each time a cycle of IVF fails. The inability to predict the fate of every fertilized egg leaves me in a realm of emotions that are unfamiliar. Logical thought cracks under bubbling superstition. The depicted creature could be fertilizing or consuming the eggs, as it articulates in unpredictable, omnipresent ways.

Creating Primordium provided me with a new perspective on my treatment process, one where violet circular forms replaced impersonal words like “ovarian” or “blastocyst.” Through acrylic paint, I spoke in a different language with a new set of rules, fully engaged in a unique form of problem solving. Painting allowed me to forget about the calendar, daily injections, and cyclic uncertainty and provided a respite from the grind of infertility treatments.

As a patient, I found empathy through my art therapy—through recruiting multiple senses and using paint to discover new points of view. Finding that empathy has afforded me a glimpse of what my own patients may experience in their illness. I can let go of known, clinical words (“This is a G4P0 38-year-old woman …”) and instead explore an emotional representation of her battle with disease. In turn, I now see the patient as a teacher and myself as a compassionate listener and, ultimately, a better surgeon.

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1. Schmidt L. Psychosocial burden of infertility and assisted reproduction. Lancet. 2006;367:379–380.
2. Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. 2015 Assisted Reproductive Technology National Summary Report. 2017. Atlanta, GA: U.S. Department of Health and Human Services; Accessed October 9, 2018.
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