Spring 2004
The author, a 1955 graduate of New York University, was elected to ΑΩΑ as a faculty member at the University of Colorado School of Medicine in 1979. He is Distinguished Professor of Medicine and Immunology at the University of Colorado and a member of The Pharos’s editorial board.
The painting “The Doctor” is a very big oil painting (5½ by 8 feet) and was considered to make an important statement as soon as it was finished. In general terms, it shows a room in a rustic cottage. A young child is lying upon a bed made out of two chairs, attended by a well-dressed man who is looking at him thoughtfully. A man, presumably the father, is dimly seen in the background. It is not clear if the boy’s mother is present. There is much to this picture. The two main characters, the doctor and the child, are strongly emphasized by the light of a lamp. The rest of the room is dark. Some light is coming through the window at the right, but it is not certain whether this is twilight or dawn. The window is set in very thick walls. One surmises that this is a country cottage. The doctor is dressed very well, as befits a professional from a class far above that of the cottagers. His top hat is on the table to the left. The man standing in the background, indistinctly seen in the semidarkness, is dressed as a worker—very different from the doctor. The handsome child seems to be asleep, and, although sick, is well nourished, suggesting that the illness is acute. The furniture is modest. The room is dark and there may be some nets drying, in which case the father is a fisherman. The doctor is very thoughtful. What is he thinking? I have always believed that he is despondent, and staring into space because he knows that there is really nothing he can do to help the child, who will recover or not regardless of his ministrations. Thus the mood of the picture is rather somber. Accordingly, the general pictorial tone is dark but with the contrasting blazing light from the lamp that illuminates the doctor and the boy. This method of dramatic emphasis reminds us of the chiaroscuro (light and dark) treatment so favored by Rembrandt and other masters. But the mood is open to interpretation. If the light in the window means the end of the day, then a long, frightening, and uncertain night is in store for the family because the doctor will soon be leaving for his own home. But if it is dawn, the implications are different. It means that a devoted physician has spent the night at his patient’s bedside, and the new day always brings hope. The painter Luke Fildes (1843 to 1927) was born in Liverpool. He was artistically talented, and received training in Chester and Warrington. He then pursued further studies in London, where he came to the notice of Charles Dickens, who asked him to make engravings to illustrate what was to be his last novel, the unfinished Mystery of Edwin Drood. Fildes had three general subject areas for his art: genre scenes, Venetian scenes (he lived in Venice for some time), and society portraits. He was extremely successful. He was commissioned to do several official portraits of royalty, including those of Edward VII, Queen Alexandra, and George V. Fildes was elected to the Royal Academy, and was later knighted by Queen Victoria.
Realism for social impact This kind of painting has been called “social realism.” It is social because it reflects current society, rather than some of the other common themes of pictures, such as the historical, religious, or mythological. It is “realistic” because it apparently shows “things as they are.” The difficult-totranslate French term, genre, covers this category nicely: scenes of everyday life. Fildes was a leader in this category. In fact, his first popular success was a large painting, called “Applicants for Admission to a Casual Ward.” It shows a crowd of poor, sick, and miserable Londoners, adults and families, waiting outside in the cold to gain admission to what we today would call a shelter for the homeless. If one thinks of such a scene as sentimental, the sentiments were not congenial to some. A critic complained, “There is little in a theme of such grovelling misery to recommend it to a painter whose purpose is beauty. . . . The state of things he represents to us ought rather to be removed than to be perpetuated, and its introduction into art which should be permanent is rather matter for regret.”(1pp52–53) For this critic, art meant “beauty,” and while he admitted that social evils, such as poverty, exist and should be “removed” from society, he didn’t want art to show us these evils. He was a long way from Picasso’s “Guernica”! Realistic pictures were not simple matters, even for such talents as Fildes’s. To ensure the desired accuracy, painters used models, not only for figures but also for backgrounds. In fact, “The Doctor” does not show us a “real” cottage, but a mock-up that Fildes constructed in his own studio. This, in turn, raises the question of whether this oil painting was meant to portray a “real” event. The story behind the painting Why was this picture painted? Ralph Waldo Emerson said, “There is properly no History; only Biography.”(2p6) For many creative people, this might include autobiography. We write, tell, paint what we know, or think we know. Yes, the picture reflects a “real” event, the illness of Fildes’s young son, Philip. This illness had occurred 13 years prior to the painting. Fildes was so impressed with the devotion of their physician, Dr. Murray, that he wanted to represent the doctor and the lad to commemorate the event and the scene. So, in this sense, the picture presents—in retrospect—a “real” event. Are the figures “real”? Fildes, of course, used live models for his art. Thus, the young boy in the painting could not have been Philip, who would have been near twenty in 1890. Fildes must have used another boy as model, and whether he looked like Philip had thirteen years earlier, we do not know. Thus the father in the background, while “standing in” for Fildes, must have been modeled by another person of about the age Fildes was when Philip was sick. That leaves Dr. Murray, the main figure in the picture. In fact, however, Dr Murray is not the main figure. We never see Dr. Murray at all, because the “doctor” is none other than Fildes himself! It is a self-portrait, but one of the mature painter of 1890 rather than of the young father of 1877. Was Dr. Murray not available (or even alive) in 1890? Did Fildes identify with a fatherly physician, a healer and protector of the young and defenseless, as any good father might want to consider himself? But there is even more to the “real” story. Many people think that the picture symbolizes the best aspects of caring and healing—the doctor as hero. The handsome and wellappointed physician is guiding his knowledge (in the form of the light) towards the young boy who will surely recover completely, thanks to medical science and human compassion, as embodied in “The Doctor.” Victory is in sight. But this was not to be so. There was indeed a doctor and a very sick child, and so the painting does recollect (even if it doesn’t copy) a real event. That is, it tells us of the illness of Philip Fildes, the painter’s own beloved son. What it does not tell us is that on Christmas Day, 1877, Philip Fildes died while under the care of Dr. Murray. In this sense, the painting is a memorial to his son and a deeply touching portrayal of a calamitous event. Why he chose himself to impersonate Dr. Murray, to whom he was apparently grateful in spite of the outcome, we will never know. And there is yet one more twist. If “The Doctor” is supposed to memorialize Fildes’s son, Philip, and to recall, however painfully, a family tragedy, why did Fildes change the venue? By 1875, he was successful enough to commission a prominent architect to build him an impressive twostory Queen Anne-style home in fashionable Kensington. In 1877, Philip would have had a comfortable bed in one of the upstairs bedrooms. Dr. Murray’s visit would not have resembled the scene in the painting at all. Was the removal to an idealized rural cottage a ploy to romanticize the plight of the poor but deserving rustic worthies (“return to nature”)? Was Fildes unwilling to display publicly his own misfortune by placing the scene in his own house? (The English are famously private in their personal lives.) The engraving, “The Doctor,” by Fildes. “The Doctor” was a great success. It was so for Fildes, because Henry Tate, the sugar magnate, paid him £3,000 for it, even when it was in design stages. When Tate gave his collection to the state (it was the nucleus of what we know as the Tate Galleries in London), “The Doctor” was a prominent item. It was also a great success with the public, so much so that an engraving was made of “The Doctor” so that more people could enjoy the image. This engraving has a very different flavor than the painting. Instead of highlighting the doctor and his patient in a dark room, the engraving has more uniform lighting. It is clearly daytime. The grieving mother, who was almost invisible in the oil painting, is easily seen, head bowed in grief at the table. Many details of the furniture and the room itself can be discerned.
Medicine and art In our newlydeveloping medical school course, Art In Medicine/Medicine in Art (partly based on the Yale University experience [3]), we have used these two versions of “The Doctor.” We exploit them to teach observational skills. We also ask what the differences in subject presentation are, what the different moods are, which is more sentimental (and is this an appropriate emotion for either picture—after all, Victorian art has greatly fallen out of favor because of its perceived sentimentality), and which was most appropriate for the postage stamp,* and why. We also ask whether knowing the “real” circumstances behind the genesis of the picture helps or hinders in its appreciation. My own opinion is that if sentimental means (in a nonpejorative sense) emotional, then this picture of a very private and very deep family tragedy has every right to be—sentimental.
Acknowledgments I am grateful to Dr. Patricia Skavlen for bringing her copy of the engraving of “The Doctor” to my attention and allowing us to use it. I also appreciate the initiative and impetus given to our art/medicine program by Ms. Susan Rymer, UCMS II. References 1. Wood C. Victorian Panorama: Paintings of Victorian Life. London: Faber and Faber Limited; 1976 2. Emerson RW. History. In: Tanner T, Bigsby C, editors. Essays and Poems. London: J. M. Dent; 1995. pp 3–22. 3. Dolev JC, Friedlaender LK, Braverman, IM. Use of fine art to enhance visual diagnostic skills. JAMA 2001; 286: 1020–21. A general reference on Luke Fildes is: Fildes LV. Luke Fildes, R.A.: A Victorian Painter. London: Joseph; 1968. The author’s address is: University of Colorado Health Sciences Center |
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