ART REVIEW

Portrait of Spain: Masterpieces From the Prado

Various artists, 2012, Queensland Art Gallery (Brisbane, July 21–November 4,art exhibition on loan)

Katrina A. Bramstedt

Received: 14 August 2012 /Accepted: 5 December 2012 /Published online: 8 January 2013# Springer Science+Business Media Dordrecht 2013

Keywords Medical humanities . Dwarfism .

Hirsutism . Professionalism . Discrimination .

Obesity . Futility

During 2012, the Museo Nacional del Prado (thePrado) in Madrid, Spain, loaned the Queensland ArtGallery a sampling of its masterpieces. Notably, thiswas the first time these works have appeared in theSouthern Hemisphere. Moreover, six works in thecollection (five paintings and one etching) are robustexamples of medical ethics fodder.

Some of these Spanish works are similar to thosefound in the Archduke of Austria Ferdinand II’sChamber of Art and Curiosities Collection at AmbrasCastle (Euromuse.net 2012). Specifically, four of thesix items are paintings that fit under the same theme—disability—and cover the topics of hirsutism, dwarf-ism, and morbid obesity.

At onset, La Señora de Delicado Imaz by VicenteLópez Portaña (circa 1833) is a striking portrait of anaristocratic woman. Her opulent dress, earrings, andhairdo speak to her station in society, although amoustache, slight goatee, and heavy eyebrows poten-tially detract the modern viewer’s gaze. Whereasimages of women today are endlessly digitally

changed and women themselves undergo various clin-ical and cosmetic techniques in order to conform tocultural ideals of femininity, this artist made no at-tempt to hide the woman’s hirsutism in this life-sizepainting (109 cm×86 cm)—with either paint itself orthe paper fan the model holds closed in one hand.What was different nearly 180 years ago, and whathas caused this shift in values today? Certainly, now,there are clinical and cosmetic techniques to addresshirsutism, but even 200 years ago, this model couldhave opted for a cosmetic cover if she desired such.Perhaps during that era the visual appearance of hir-sutism did not carry the stigma it does today? Orperhaps the artist and the model felt that the jewellery,fancy dress, lace scarf, and lavish hairdo were forms ofbeauty that rendered the hirsutism insignificant?

Dwarf With a Dog (artist unknown, circa 1640) andThe Boy From Vallecas by Diego Velázquez (circa1640) both display painted images of males of shorterstature as a “showcase.” According to the museumdocent and documents accompanying the paintings,these men were often “collected” by nobility and keptin the household for purposes of entertainment. TheBoy From Vallecas, for example, depicts FranciscoLezcano, a young man ready to entertain the royalcourt with playing cards—perhaps card games or cardtricks. Seen as a “curiosity,” Lezcano and others weresupposedly well-treated members of the royal court;however, one wonders how “well-treated” a personcan be who is thought of as a “prized possession”and used a means for another’s pleasure. In the paint-ings, the young men are mocked by virtue of bold

Bioethical Inquiry (2013) 10:121–122DOI 10.1007/s11673-012-9420-9

K. A. Bramstedt (*)Bond University School of Medicine,University Drive,Gold Coast, QLD, Australia 4229e-mail: txbioethics@yahoo.com

costumes and imagery that enhance their height defi-cits (e.g., including tall objects adjacent to them).“Disability rights” movements and laws are part of aculture change in recent the years, but there are pock-ets of exploitation that remain; for example, “dwarftossing” is illegal in only a few jurisdictions.

King Charles II of Spain had another personal“collectible,” namely, 6-year-old Eugenia MartinezVallejo. Morbidly obese for her age at 70 kilograms,this young girl was painted by Juan Carreño deMiranda and named The Monster. In her portrait,Eugenia is dressed in fancy garb, including decorativehair ribbons; however, her face does not exude joy orpride but, rather, uncomfortable irritation with hermodelling role. Modern speculation is that she wasthe victim of Prader-Willi syndrome, a conditionevidenced by hypotonia, short stature, excessivefood-seeking behaviour, and intellectual impairment.Most people with Prader-Willi syndrome have an IQin the mild intellectually disabled range and evidencespeech and memory difficulties as well as languageprocessing problems. Like Lezcano, Eugenia provided“entertainment” for noblemen and their children.While these individuals were “valued” by their hosts,one wonders if these hosts also advocated for them orif the hosts tolerated bullying and taunting children(and others) likely inflicted. Answering these ques-tions requires delving into both art history and artscholarship, but the questions themselves are valuableto stimulate inquiry and reflection on times past andpresent.

Francisco Goya’s etching Of What Will He Die?(circa 1797) depicts a donkey dressed as a physicianwho is taking the pulse of a dying patient. Not only isthe physician shown as a “jackass” but the animal’seyes are closed as he performs the assessment, clearlyunable to visualize his wristwatch during the pulsecheck. Perhaps the etching would have been bettertitled When Will He Die? as it is certain this “physi-cian” will be unable to offer any help to his patient. Inmy view, the etching pokes fun at the medical profes-sion, a realm that sometimes views itself as omniscientand omnipotent.

In the concluding room of the exhibit was the mostprofound example of medical humanities in the col-lection. The Madness of Joanna of Castile by Lorenzo

Vallés (1866) is a reflective journey of many ethicsconsultations in hospital intensive care units. Thismassive painting (238 cm×313 cm) depicts futilityas its best (or worst, however you want to frame it).Queen Joanna of Castile, pregnant with her dead hus-band’s child, stands boldly at his bedside, forbiddinganyone from squashing her belief that the king willawaken and arise. Her chair is dutifully placed next tothe bed so that she can sit vigil, and she wears a rosaryaround her waist for constant and easy access to God.Her outstretched hand pushes away anyone in herpath.

This scene, while occurring nearly 150 years ago,resembles what clinical ethicists today often encounterwhen family members refuse to accept clinical futility(including the declaration of death). Next of kin laytheir bodies atop their relative, adorn them with reli-gious documents and amulets, and screen out visitors(and health care providers) who offer information theyview as negative (e.g., proposals for withdrawal orwithholding of interventions, comfort care, death as-sessment). These behaviours can be the hallmark offutility denials, but they can also be a form of griefexpression or even “closure” as well. In the case ofJoanna of Castile, she definitely was rejecting theclinical death of her husband. Interestingly, becausemedical technology continues to advance, future art-works likely will continue to evidence displays ofmedical futility.

The Prado collection contains wonderful examplesrelated to the medical humanities that can be used ascurriculum materials for students in the health scien-ces. Students, academicians, and clinicians can viewmost of these works online as well.

Disclosure I am an Associate Editor for the Journal of Bio-ethical Inquiry.

Reference

Euromuse.net. 2012. Collections of Ambras Castle. http://www.euromuse.net/en/museums/museum/view-m/sammlungen-schloss-ambras/.

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