The Doctor (painting)

Self-portrait, Luke Fildes, 1911. Royal Academy of Arts, London.

The painting was commissioned by Henry Tate in 1890 as a work of "social realism" on a topic of Fildes' choosing to be displayed in the National Gallery of British Art, now known as the Tate Gallery London.[1] Fildes was paid £3,000 for the work, a sum he felt was too small for such a painting and less than he expected for painting portraits.[2] Two Victorian doctors, Dr Thomas Buzzard (neurologist) and Dr Gustavus Murray (obstetrician), have been particularly associated with the painting, as has the genre of the period in which it was painted.[3] Fildes had the particular desire "to put on record the status of the doctor in our time".[1]

Different theories exist as to the origins of the painting.[4]

Fildes' personal loss

The most important personal influence was probably the death of Fildes' first child, his one-year-old son, Philip, from typhoid fever on Christmas morning, 1877.[5] Fildes' biographer has described how the boy's death compelled Fildes to paint a picture revolving around the compassionate Dr Murray visiting his dying child. The story was confirmed later by Fildes' second son, who described this as Fildes' "quickest painted of his 'big' pictures".[6]

The Widower, Luke Fildes, 1876.[7] A precursor of The Doctor.

Fildes stated that his choice of subject was "to put on record the status of the doctor in our own time",[4] but his depiction of 19th-century healthcare is not entirely accurate. There is no stethoscope, microscope, sphygmomanometer, or thermometer in the picture, well-known instruments of physicians in the late 19th century which saved time.[4] It may be that these instruments were omitted in order to show the doctors' "professional and personal commitment".[6] Fildes does include a pestle and mortar, and a cup and a spoon, equipment used before the scientific era of medicine.[4]

It has also been pointed out that it was unlikely that a Victorian physician would make an overnight home visit to a poor family, such services being available only to the middle class and the wealthy.[4]

The Doctor used ironically in a 1911 Punch cartoon by Bernard Partridge commenting on the effects of the National Insurance Act 1911[14][15]

The painting caught the public's attention and toured Britain. Received with a striking admiration, there is one report of an observer who, overwhelmed at the painting, died on the spot.[9] The work is considered one of the most famous depictions of the practice of medicine and has been described as "iconic".[6] It epitomises an idyllic kind of medicine[1] and has often been used to illustrate the virtues of a good doctor and the inadequacies of the medical profession.[4]

Subsequently, the painting received comments including this by surgeon W. Mitchell Banks: "What do we not owe to Mr. Fildes for showing to the world the typical doctor as we would all like him to be shown – an honest man and a gentle man, doing his best to relieve suffering?" He continued: "A library of books written in your honour would not do what this picture has done and will do for the medical profession in making the hearts of our fellow men warm to us with confidence and affection".[9]

Seen today as "Victorian spin" by some, in its time the depiction of the doctor as a hero serving the poor raised the status of the medical profession during a period when public opinion was critical of the increasingly impersonal nature of medicine.[4]

The Doctor, after Luke Fildes, Joseph Tomanek, 1933[16]

AMA Centennial stamp of the United States, 1947

The painting has inspired poetry and film.[4] In 1911 it featured in a Punch cartoon commenting satirically on the effect of the National Insurance Act 1911 on doctors.[14] In 1933, the American artist Joseph Tomanek painted a version of the painting making small changes to the composition.[16] In 1947 it was reproduced on a United States postage stamp for the centenary of the American Medical Association,[9] which in 1949 used it in their campaign against nationalised medical care as proposed by President Harry S. Truman. The image was printed on 65,000 posters and brochures with the slogan, "Keep Politics Out of this Picture". This has been described as contributing to public distrust of nationalised medical care in the United States.[17] By contrast, in Britain it was used as the emblem for a celebration of Britain's National Health Service.[9]

In 1933, a sculpture of the scene in the painting was made using the "life-size, life-like, new art form" of sculpticolor and displayed at the Petrolagar laxative exhibit in the Hall of Science at the Chicago Century of Progress exhibition. It was cast from a model made by the sculptor John Paulding and then painted by Rudolph F. Ingerle, the entire work measuring 15 feet (4.6 m) in length, 11 feet (3.4 m) in height, and 9 feet (2.7 m) in depth. Publicity stated that "The Doctor impressively emphasizes the ideal relationship between physician and patient - 'The Human Touch'".[18][19]

As late as 1951, the painting was used in advertising for Wyeth pharmaceuticals, which repeated the story that Queen Victoria commissioned it, adding: "the pictured child recovered despite the inadequacies of her humble home–a tribute to her doctor's genius and to the progress of medical science".[20]

Since the mid-1990s, the medical humanities journals The Lancet and the British Medical Journal have revived interest in the painting, stimulating discussion about the role of the doctor.[9] Debate on the role and status of doctors has led to the inclusion of medical humanities in medical schools, where this painting has been used as a teaching aid for medical students.[5]

The reason for the painting's popularity has been much debated. The universal sentiment associated with a doctor tending to a sick child appears simple. Ultimately, it is likely that The Doctor was hailed as iconic due to the wish to be cared for with single-minded attentiveness.[9]

Media related to The Doctor (1891 painting) at Wikimedia Commons