“The Doctor”A commentary on Luke Fields

painting, “the Doctor”Farhad Zargari, MD, PhD

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Biography

• Sir Samuel Luke Fildes, 1843 -1927) was an English painter and illustrator born at Liverpool and trained in the South Kensington and Royal Academy schools.

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Biography

• Fildes shared his grandmother's concern for the poor and in 1869 joined the staff of The Graphic newspaper.

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Biography

• Fildes' illustrations were in the black-and-white style popular in France and Germany. He worked in a social realist style, and focused on images about living conditions in London.

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Biography

• The Graphic published an illustration completed by Fildes the day after Charles Dickens' death, showing Dickens' empty chair in his study; this illustration was widely reprinted worldwide.

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Biography

• In the first edition of The Graphic newspaper that appeared in December 1869, Luke Fildes was asked to provide an illustration to accompany an article on the Houseless Poor Act. The picture produced by Fildes showed a line of homeless people applying for tickets to stay overnight in the workhouse.

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Biography

• Fildes soon became a popular artist and by 1870 he had given up working for The Graphic and had turned his full attention to oil painting. He took rank among the ablest English painters.

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Edward VII in coronation robes (1901)

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Flower Girl (1877)

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“The Doctor”

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The Doctor

• Fildes' celebrated 1887 work, The Doctor, depicts a Victorian GP on a home visit. He is watching over an impoverished laborer's sick child; the bed is makeshift, two non-matching chairs pushed together. The central figure is the imposing male doctor, gazing intently at his patient, while in the background the father looks on helplessly his hand on the shoulders of his tearful wife.

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The Doctor

• The Doctor, shows a GP on a home visit. He is watching over a worker’s sick child; the bed is makeshift, two non-matching chairs pushed together. The main figure is the doctor, gazing intently at his patient, while in the background the father stands worried with his hand on the shoulders of his tearful wife.

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The Doctor

• Different stories exist about the origins of the painting. It may have been inspired by the death of Fildes' eldest son, Phillip, who died on Christmas morning 1877, attended by a Dr Murray, who impressed Fildes with the care and attention he gave to his dying child.

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The Doctor

• The painting shows how humanistically the doctor is watching his patient with kindness, affection and attention.

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The picture received much praise from contemporary critics:

• British Medical Journal in 1892:

“ What do we not owe to Mr Fildes for showing the world the typical doctor, as we would like to be shown — an honest man and a gentleman, doing his best to relieve suffering?”

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Mitchell Banks, MD, FRCS, 1893, Professor of Anatomy, Royal Infirmary,

Liverpool

• “A library of books written in our honor would not do what this picture has…”

• “Remember always to hold before you the ideal figure of Luke Fields picture, and be at once gentlemen and gentle doctors.”

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Postage Stampsin 1949

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The Doctor in AMA Campaign

• In 1949 Fildes' painting, The Doctor, was used by the American Medical Association in a campaign not to politicize the Medicine.

24Kee

p Polit

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his Pic

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!!!

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The LancetJuly 1998

• In July 1998, The Lancet reproduced the painting to mark the anniversary of the National Health Service in the UK.

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The Missing Part of Today’s Medicine

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Dr. BrodyFamily Med. Magazine, Sep 1998

• Medical practice is more the maintenance of a network of human relationships than the application of scientific knowledge.

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History and Physical Exam

• The medical technology predisposed doctors to the negligence of due attention to their patients. Financial issues made the situation even worse. The typical doctor of today depends more on test results, imaging and other paraclinical procedures than medical history and physical examination.

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New Testament

• “I was ill and you cared for me.” Matthew 25:30

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Holy Quran

• And whoever saves one - it is as if he had saved mankind entirely. 5:32

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Dr. Hogarth:

• “… as long as medical treatment has been a commodity to be bought and sold, the quality of treatment has varied according to the social status of patients”

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The Doctor in our time!!!After Dr. Verghese A, NEJM 359:26;2008: Culture Shock

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• References

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• 23. MORI poll. Opinion of professions. London: Ipsos Mori; 2005.

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Thank You For Your Attention