Friday, 30 November 2018

“The Doctor” – then and now

Visitors to Tate Britain will be familiar with the painting "The Doctor" by Sir Luke Fildes RA (see below). As it is highly melodramatic, in a style loved by Victorians, it is easy to relate to the feelings of the subjects, especially as these focus on the serious illness of a child. Fourteen years before he painted “The Doctor” in 1891[1], Fildes lost a one-year-old son and there is no questioning the message of the work, however unlikely the scene was in reality. The painting shows the power of art across the centuries – and it makes us ask questions.

“The Doctor” is carefully composed and Fildes constructed a cottage stage set in his studio to help him create the scene (see below); the interior being based on a fisherman’s cottage in Hope Cove in South Devon that the artist had visited and sketched [1]. The decoration and furniture of the cottage are humble and we can imagine them to be quite different to those of the doctor’s residence. We also notice that the doctor is dressed well, in contrast to the dimly-lit parents of the child being treated.

The scene is illuminated by an oil lamp and the lighting keeps returning our attention to the doctor and his patient. Some light comes through the small window in the cottage, but the plain curtains are drawn and we thus conclude that this was a night call and that the doctor had been with his patient for some time. A bottle of medicine and a cup and spoon have been placed on the table and we imagine that these were involved with the treatment that the child is receiving. While the doctor focusses intently on his patient, looking for signs of improvement, the father of the child maintains a stoic approach and comforts his wife, who cannot look. She seems consumed with maternal distress and anxiety – death of children being a common experience of many families at the time of the painting – and both parents are background figures to the story being told.

In his 1895 biography of Fildes, David Croal Thomson writes [2]:

This composition of “The Doctor” has been recognised by the medical profession as a great and lasting compliment to the whole body. No more noble figure than the doctor could be imagined – the grave anxiety, supported by calm assurance in his own knowledge and skill, not put forward in any self-sufficient way, but with dignity and patience, following out the course his experience tells him is correct; the implicit faith of the parents, who, although deeply moved and almost overcome with terrible dread, stand in the background trusting their doctor even when their hearts fail.

It is a powerful accolade for family doctors and the faith placed in their expertise, concern and diligence. If this was true of 1895, is it still true today? Of course, the provision of medical care varies from country to country and we are fortunate in the UK in having a National Health Service (NHS). However, I’m not sure how many of us have a family doctor who knows us, our medical history, and our circumstances. That’s to be expected in a system under economic stress and with doctors having increasing numbers of patients to look after and with these patients living into old age, with the accompanying array of illnesses that come with senescence.

In the town where I live, it is difficult to make appointments to see a general practitioner and, when one does, the information on our health record is stored on a database that must be read in detail to provide a background to any consultation. Reference onward to a hospital specialist takes time, and appointments may be on days that are months ahead. It might be regarded as an efficient system, but it doesn’t feel like it, and the compassion shown by “The Doctor” is not always present. As to home visits, they are out of the question and, if one cannot get to the surgery where the doctor sees patients, the alternative is to make a telephone call to a remote practitioner who can only advise on the symptoms that one describes – sometimes difficult if one is feeling very unwell.

There is no question that general practitioners care, are highly trained, and, for the most part, competent. It is a tough job, and comes with its own stresses, but there is the compensation of a good salary, the chance to work part-time, and a high status in society, something which can cause a small minority of doctors to believe in their superiority. We don’t know any details of “The Doctor” in the painting, but we do note that he is of a very different social standing to his patients, yet there is no question that he has put himself out and is dedicated to ensuring recovery, if at all possible. How relevant are those qualities today in the age of the spreadsheet, MBA-speak, and layers of “management”?

[1] (a larger image of the work can be seen here)

[2] David Coral Thomson (1895) The Life& Work of Luke Fildes RA - from The Art Annual. London, J.S.Virtue & Co..

I would like to thank Tate Britain for allowing me to reproduce the image of “The Doctor”.

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