Practical Activity 1: Goya’s Physician and the Art of Caring

• Supporting others
• Showing respect and consideration to others

Images of 4 famous paintings printed in colour in minimum A4 size:

• Self Portrait with Dr. Arrieta (Goya, 1820)
• The Anatomy of Dr. Tulp (Rembrandt, 1632)
• Portrait of Dr. Gachet (Vincent Van Gogh, 1890)
• The Gross Clinic (Thomas Eakins, 1875)

The learners have to observe, analyse and put themselves in the scenes shown in the pictures, practicing empathy. Then will be asked to reflect upon it.

1. Show the learners the 4 paintings of physicians, created by famous painters.

2. Ask the learners to observe attentively each of the paintings, describe the characters and try to understand what is happening in the scenes. Follow the guide for each painting:

Self Portrait with Dr. Arrieta (Goya, 1820): The painting shows Dr. Arrieta holding a pale and weakened Goya as he administers medicine. The positioning and gesture of the doctor’s hands express a determination to get his patient better, and his face shows kindness and caring. In the background are mysterious dark figures that might represent the nightmares of a man in a state of delirium. This oil painting was created in 1820 when the artist was 74, and 8 years before his death. The artist had already achieved great fame as painter to royal courts of Spain. Goya had been afflicted for years with medical problems that left him deaf and partially blind.

The Anatomy of Dr. Tulp (Rembrandt, 1632): shows a flamboyantly dressed professor teaching anatomy to a group of learners. The teacher’s clothes demonstrate his rank and wealth as he gives the demonstration, but the portrait does not reflect caring for the sick.  

Portrait of Dr. Gachet (Vincent Van Gogh, 1890): depicts a man who appears melancholy or bored, leaning his head against his hand. In front of him are two novels and a foxglove plant, from which digitalis is extracted. There is no indication that the subject is a physician other than the medicinal plant in front of him and Van Gogh’s letters, and not much caring or compassion comes across. However, knowing that he is Van Gogh’s doctor, you might imagine that he is contemplating the artist painting him, watching in pity a penniless and tortured soul toiling away. 

The Gross Clinic (Thomas Eakins, 1875): . In this painting the doctor with bloody hand and scalpel is looking away from an unconscious patient on the operating table whose leg is being cut. To the viewer’s left and behind Dr. Gross is a person in distress, possibly the patient’s mother, and the great doctor shows no reaction or empathy. Dr. Gross might have been a skilled surgeon and teacher, but compassion does not seem his forte, at least in this portrait. 

Other considerations:

Self Portrait with Dr. Arrieta (Francisco de Goya, 1820) is considered one of the best portraits of a physician in the history of western art. Goya’s doctor shows deep compassion and a fierce will to improve the health of his patient.

When we compare Goya’s image to these paintings, we begin to appreciate the qualities that are displayed in Dr. Arrieta through the artist’s skilled hand. The attributes of compassion and caring are difficult to measure in board examinations and may not matter much in today’s data driven healthcare environment.  Yet these qualities are so important in establishing a relationship with a sick patient.   

The process of entering a physician-patient relationship is an intimate, challenging experience that should not be taken for granted, and we as physicians have the ability to change people’s lives.  In Dr. Arrieta’s case, he enabled Goya to live another 8 years and further express his genius in art, which was a gift to the world.  Perhaps this painting needs to be distributed to every medical student as the ideal to be attained through training as a physician.

3. Ask the learners to choose one of the characters of any of the painting and THINK AND FEEL as if they were that character of the scene. They may choose to be the medical doctor, the patient, the patient’s mother, the medical learners, etc.

4. Ask the learners to consider how they would feel in that character and how they would behave. After thinking and feeling as the chosen character, will there be any change in the way they would choose to be painted?

• Which character shows compassion and caring, and which one not? What do you think about his/her reaction?
• Do you think that medical doctors show compassion and caring in current times?
• What can you do in your environment to be more supportive to others?

Mix age groups and analyse the difference in the answers 3 and 4 of the procedure. Is there any difference among their considerations?