The images suggest the palette of artist Edvard Munch. 

Horizontal swaths of lavender, blue, and pink slashed with dark indigo streaks. Skies of mottled gray highlighted with hints of yellow, green, and blue. They are microcosms of art in tiny samples of human skin.

Through a microscope, Peter Hauer, an adjunct faculty member and general supervisor in the University of Utah's Cutaneous Nerve Laboratory (CNL), has been looking at variations of these masterpieces for decades. Where art speaks to the human soul, skin samples speak to Hauer in ways that define physical human health.

Neuronal marker PGP 9.5, which is kind of like a liquid highlighter, makes the layers of a skin biopsy (a tiny piece of tissue no bigger than a pencil eraser) and its nerves visible. 

Healthy nerves appear as delicate indigo threads weaving through bands of pink and lavender. When those threads disappear, Hauer doesn't see abstract shapes. He sees disease.

Pharmaceutical companies rely on Hauer's interpretation of these landscapes to tell them if new medications will help or harm the nervous system.

Although Hauer oversees the CNL, he is quick to redirect credit to lab manager Adrienne Aperghis and senior lab specialist Brooke Van Noy.

"The lab would not function without them," he said, "I try to stay out of their way. They try to keep me pointed in a straight direction."

Their teamwork has been remarkably effective. 

Three people. Over 200 referring centers. Multiple pharmaceutical trials running at once. And the CNL has zero CAP inspection infractions.

The lab’s story begins not with a microscope but with a problem. In the 1980s, Hauer worked at Johns Hopkins. There, patients with neuropathy (burning, tingling, or numbness) in their feet endured invasive surgical biopsies deep in the calf for diagnosis. 
The procedure was painful, left patients with permanent numbness, and often missed the damage entirely.

The problem was location. 

Most nerve damage follows a pattern. It starts at the farthest nerve endings, like the delicate nerve fibers in the foot, not higher up in the leg. Doctors were looking in the wrong place.

"We said, ‘Okay, let's take a small skin punch from the heel, the very terminal ending of those nerves, and compare it to what we're seeing in the calf,’" Hauer recalled. "We found that sometimes the calf looked normal, but the nerves in the heel were wiped out."
Skin biopsies offered clear advantages: they were minimally invasive, repeatable, and capable of detecting the earliest stages of nerve loss. 

A 3mm skin punch, a bandage, and the patient walks out the door. Later, the same site can be re-biopsied to see if treatment is working or if damage is spreading.

Pharmaceutical companies noticed. 

After Hauer moved to the University of Utah, the CNL became a central laboratory for multi-center pharmaceutical trials, shipping biopsy kits to clinical sites across the country, training physicians and coordinators, and processing samples that can determine whether experimental medications advance to the next phase of development. 

"There's a concrete way of measuring this," explained Hauer. "We give a density: nerve fibers per millimeter. Biopsy before the drug. Biopsy after. Compare. It's very hard to argue with a number."

That number, however, is only as trustworthy as the lab producing it. The CNL is a CAP-accredited clinical diagnostic laboratory, subject to rigorous testing every six months. A lab result from Salt Lake must mean the same thing as a result from New York or Texas; CAP accreditation assures that.

Aperghis and Van Noy, says Hauer, are largely responsible for the lab’s record of excellence. "You have to dot every 'i' on a patient's chart. ... To find people like Adrienne and Brooke who are that detail-oriented — that's why this lab functions at the level it does."

The CNL does three things: diagnoses patients, supports research, and runs pharmaceutical trials, all with a team of three. They’re a team that operates almost entirely without public fanfare.

"People don't know we exist," Hauer said, almost cheerfully. "We're just here doing the work."

That work, quietly, is substantial. The lab has been involved in trials spanning diabetic neuropathy, HIV-related nerve damage, bariatric surgery recovery, and emerging genetic therapies. It also built the baseline nerve density data — by age, sex, and ethnicity — that drug companies depend on.

The next time a pharmaceutical company announces a breakthrough therapy for damaged nerves, chances are a tiny skin sample, processed in a Salt Lake City lab by a team of three, helped make the case.

In the Cutaneous Nerve Laboratory's microscope slides, indigo threads meander through lavender and pink. To most people, they look like abstract art. To the team, they're evidence. Evidence of disease. Evidence that a treatment is working. Evidence that, for someone still searching for answers, healing may be possible.