science of us

Is This Blood Clot Horrifying — or Beautiful?

Photo: Woodward et al./NEJM

What you see before you is not a tiny, exotic plant. It is not a piece of wood whittled and dyed for one’s true love, to wear in a locket around her neck. It is not a piece of coral from the Great Barrier Reef. No, what you see before you is a blood clot in the shape of the right bronchial tree, coughed up intact. It is beautiful.

The photo comes from the New England Journal of Medicine, released at the end of November as part of its Images in Clinical Medicine series. The intact clot comes from a patient who suffered from chronic heart failure and who was, at the time, being treated for acute end-stage heart failure.

The patient’s heart was connected to a pump designed to help maximize blood flow. Georg Wieselthaler, transplant and pulmonary surgeon (and the patient’s doctor), explained to The Atlantic that the use of this pump had the risk of complications. “You have high turbulence inside the pumps, and that can cause clots to form inside,” he said. “So with all these patients, you have to give them anticoagulants to make the blood thinner and prevent clots from forming.”

The patient was given the anticoagulant Heparin, which resulted in him coughing up a series of smaller blood clots. Eventually, after an “extreme fit of coughing,” and in what must have been a tremendous relief, he coughed up the bronchial tree blood clot we’re talking about today. He died of complications from heart failure a week later.

What remains is this astounding, perfectly formed cast; something “very, very, very rare,” as Wieselthaler told the Atlantic. But is it very beautiful?

For the sake of honesty, we must note that many (on Twitter) have pointed out that this blood clot is, in fact, quite horrifying. Okay — yes, it is coagulated blood in the shape of a lung’s tubular networks. Plus it was coughed up, and generally things that are made of blood and coughed up are not considered “beautiful,” at least in the stereotypical sense. But this one is pretty amazing, I think. Vibrant red, branches reaching; a medical wonder. Arrows around it pointing at I don’t know what.

It’s beautiful, if you ask me. Do you agree? Of course you can have your own opinion.

Is This Blood Clot Horrifying — or Beautiful?