The first images that I tried to generate from Dall-E Mini were of cartoon characters getting colonoscopies. The website, now called Craiyon, houses an artificial intelligence model that turns any submitted string of text into pictures. I’m a practicing gastroenterologist who identifies as online, but not very, and the viral tweets that introduced me to the model also served as my yardstick for submissions that felt appropriately niche. Those early efforts bore mixed results: Daffy Duck was shown standing atop a stretcher, Porky Pig registered as an actual pig, and Bugs Bunny was inserted directly into a human colon, his gray ears bleeding into its pink folds.
I’ve since defaulted to the curated experience of Twitter accounts like Weird Dall-E Mini Generations, a sort of greatest hits collection culled from Reddit. Popularity in this genre relies on a specialized calculus, squaring the creativity of a user’s written input with the fidelity of its visual output. What’s struck me most, though, is their early tendency toward medical themes—“car mechanic installs a kidney in the engine,” “a DJ laying down sick beats in the cardiac ward,” “wikihow how to impress your wife with a lamp built from your intestines,” etc.
Making jokes at the convergence of high and low follows a time-honored recipe (see also Weird Dall-E Jesus and 9/11), and the commonly recognized sanctity of medicine is ripe for profaning. Maybe the medical preoccupation is just a developmental phase for the Dall-E Mini phenomenon, akin to an adolescent sense of humor. The crude equivalence between “weird” and “transgressive” echoes the images’ own technical crudeness, including a bias toward smudged, featureless faces that gives them an almost nightmarish quality. By the same token, scrutinizing these images for patterns can seem like an exercise about as useful as the interpretation of dreams. Even so, I wonder what to make of the fact that, when our collective imagination was presented with this powerful new canvas, it wasn’t just my mind that drifted in a clinical direction.
Granted, conventional narratives of medical progress have always hinged on the transformation of past fantasy into future reality: a failing organ successfully transplanted, a terminal cancer cured. Over the past few centuries, these achievements have consolidated the perceived power of medical science while also making the body increasingly legible. Lately, though, the zeitgeist’s vision of health care has had a darker cast. There’s the still-smoldering pandemic with its long tail of death, disability, and socioeconomic upheaval; the repeated collision between politics and public health in the United States, sparked by Covid and accelerated by partisan legislation around assault rifles and climate change; and the recent culmination of a decades-long offensive against reproductive rights, radically redefining American medicine’s capabilities from the outside.
Some clinically themed Dall-E Mini submissions bear the imprint of current events fairly plainly—“plague doctor onlyfans,” or “fetus with a gun.” Others, however, seem inspired by a more generalized mood of biomedical surrealism. Contemporary strains of clinical fantasy, unlike the usual rhetoric surrounding biomedicine’s triumphant march forward, seem to tug society in the opposite direction, undermining both scientific authority and the basic precepts of human physiology. That mood is in keeping with the software’s guiding spirit (Salvador Dalí is one of its namesakes), but also with an awareness that these are especially surreal times for biomedicine in the real world.
Whether that surrealism manifests conspicuously or at the fringes, we are awash with fantastical representations of how the body works. The Ohio state legislature considered a bill in 2019, for example, that mandated an ectopic pregnancy be treated by reimplanting the embryo into the uterus, despite such a procedure being medically impossible. Ambient conspiracy theories around coronavirus vaccines suggest they can change your DNA, render you infertile, and/or facilitate your geolocation. Certain popular health trends—“horse drugs, but for people”—sound almost as if they were reverse-engineered from Dall-E Mini prompts.
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More recently, in the wake of the Supreme Court’s overturning of Roe v. Wade, obstetricians are adjusting to a radically new vision of hospital-based perinatal care, one in which patients must be watched drifting closer to death until it’s suitably heroic to save their lives. The laws that say so have been put forward by a cohort of nonprofessionals who generate their own confident representations of the body and its limits, unburdened by clinical nuance, as simple as a cartoon. In a certain light, these hastily passed bits of medical legislation resemble Dall-E Mini images—a familiar context warped to accommodate a foreign idea that’s been shoehorned in, its details left disconcertingly blurry.
Forecasts are grim for any near-term return to normal. A highlights reel from a Republican primary debate for the Arizona governorship went viral this summer around the same time as AI-generated memes. On the topic of abortion, one candidate asked, “Why can’t we treat human life the same way that we would treat alien life discovered on an alien planet?” This baffling non sequitur positions clinical surrealism as a logical conclusion, as if the workings of our bodies were opaque and thus up for grabs. Writer and podcast host Erin Ryan summarized the video on Twitter with a deadpan diagnosis: “Everyone has lead poisoning.” The medical logic of inept politicians is jarring enough to presume that the ineptitude might itself be circumscribed by a medical explanation.
It’s a joke, of course—contrived for bitter laughter, made in response to our increasingly absurd circumstances. Clinical images generated from Dall-E Mini, while rarely so politically charged, aim for humor steeped in similar absurdity: “medical illustration of a burrito,” for instance, or “during heart surgery, one of the surgeons pours nutella into the heart.” It’s tempting to believe that visions of medical transgression might have been energized by the extremity of conservative arguments about the body’s inviolability. It’s also tempting to suppose that accumulating disappointments in the health care arena might spur collective fantasies of a better tomorrow. But it feels more likely that, if anything, these images reflect a brewing nihilism about modern medicine and its limits.
In addition to marking Dall-E Mini’s introduction to wider audiences, this past June was also the first time I went to a movie theater since the start of the pandemic. The film I saw was Crimes of the Future, directed by David Cronenberg, a pioneer in the genre commonly called “body horror.” Crimes of the Future portrays a world that has solved the problems of pain and infection, which ends up transforming surgical interventions into modes of art and leisure. Onlookers gather to watch performers flay their cheeks open, sew their eyelids closed, and remove visceral organs that grow without clear physiologic purpose. Cronenberg leaves the point of his allegory unsettled, but its approach resonates with clinical Dall-E memes, which likewise anatomize the body and find it rife with nonsense. Unlike in the world of the film, our physical vulnerabilities have been amplified lately rather than resolved. But in both cases, the tools of medicine appear to be losing their original utility, leaving them free to be repurposed as tools of recreation.
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A common critique of my profession is that we suffer from a failure of imagination, which holds true despite our steady emphasis on innovation. Research in gastroenterology is keenly interested in artificial intelligence, for example, but its applications have been surprisingly narrow, with heavy emphasis thus far on augmenting the successful endoscopic detection of precancerous lesions. These outpatient procedures represent my specialty’s bread and butter, determining both our therapeutic approach and our financial bottom line, but they don’t necessarily move the needle on public health.
Meanwhile, Dall-E Mini represents a no-frills version of a more deluxe AI model called Dall-E, which in turn is a likely prelude to other models that are still more powerful. Predictions for this technology’s long-term disruptive potential abound, from the proliferation of audiovisual deepfakes indistinguishable from authentic footage to the emergence of an artificial superintelligence whose motives defy those of its creators. In the face of such fundamental threats, it’s hard to imagine the medical status quo retaining its claim to the protection of our collective health.
There’s a playfulness to Dall-E Mini output that goes hand-in-hand with the software’s experimental, do-it-yourself spirit. That spirit appears to filter readily into whatever subject matter a user’s images might favor, the human body included. The tidy, well-ordered assumptions of clinical medicine have thus far remained fixed in a world that’s moving in an increasingly chaotic direction. If by consequence the field’s authority continues to erode, non-clinicians may be increasingly inclined to determine on their own how best to take care of themselves and each other.
On its own, this forecast isn’t necessarily a bad thing—indeed, certain critics of biomedical hegemony have called for such change at length. At the same time, though, alternative visions of physical possibility, whether formulated in jest or earnest, will also have an easier time percolating into the popular consciousness. Scrutinize AI-generated memes long enough, and the medium starts to communicate its own subversive message. Things feel primed to get a lot weirder, medically speaking.