Commentary by Daria Crittenden, MD, PGY-2
Please also see the clinical vignette presented before grand rounds on the 18th of March.
In grand rounds two weeks ago, March 18, 2009, Dr. Sherwin Nuland, Clinical Professor of Surgery from Yale University, ethicist, and acclaimed author, presented his lecture “Artists Portray the Art of Medicine.” Dr. Nuland’s lecture provided a visual tour through a collection of paintings and art of other media that he has assembled over many years. The works that he cited depicted the various aspects of medicine.
First, he discussed “art as didactic” with an example of 14th century depictions of the “four humors” designed to instruct medical students of the time. He cited “art as jeremiad,” using a 1496 work about syphilis that warned citizens of the disease’s terrible complications. He gave several examples of art capturing important moments of the history of medicine, such as a painting of foxglove from 1785, after Dr. William Withering discovered that its extract –digitalis– could be used to help patients with anasarca. In the early 19th century, a local artist named Lamqua depicted amputations being performed in China by Dr. Peter Parker. Decades later, the American surgeon Dr. Samuel Gross was portrayed performing a non-sterile operation on a child with osteomyelitis, with a gallery of spectators that included the patient’s distraught mother. In another scene of late 19th century surgical theatre, Dr. Theodore Billroth was shown performing a sterile surgery performed under aseptic conditions in Vienna. Of particular significance for the world of surgery and anesthesia, Robert Hinkley’s canvas from 1846 depicts Dr. Warren of Mass General Hospital conducting perhaps the first surgery with full anesthesia, after the discovery of ether for this purpose.
Dr. Nuland gave examples of art as a testament to religious faith, such as the Raphael painting in the Vatican in which a person suffering from seizures is healed by God. Art also had a role for social commentary related to the field of medicine, such as the 17th century French, Dutch, and Flemish depictions of unscrupulous cons who would conduct false “uroscopy,” examining a victim’s urine and then providing a false diagnosis of his medical problems. Dr. Nuland gave a touching example of “art as encomium,” showing a Wyeth painting of one of the first female pediatricians in the early 20th century America. She cared for the artist’s children with great devotion, prompting his portrait of her.
The lecture closed with the 1887 Luke Fildes painting “The Doctor,” showing a physician sitting at the bedside of a dying child in a rustic English farm house. The artist captures medicine at its best and worst. The child’s death is inevitable, and the sadness of the scene is palpable. But the doctor in the scene also does the patient and her family a great service with his professionalism and compassion. Dr. Nuland suggested that this image should remind us of the potential our profession holds for helping out patients – perhaps even when we cannot heal them.