Hektoen International

A Journal of Medical Humanities

Francisco de Goya: a portrait of illness

Trang Ngoc Diem Vu
Rochester, Minnesota, United States

Self-Portrait with Dr. Arrieta, 1820
Francisco Jose de Goya y Lucientes
Minneapolis Institute of Arts
The Ethel Morrison Van Derlip Fund

Francisco de Goya’s Self-Portrait with Dr. Arrieta is a Romantic painting illustrating one of Goya’s most severe bouts of illness. The inscription beneath the scene reads, “Goya, thankful to his friend Arrieta: for the skill and care with which he saved his life during his short and dangerous illness, endured at the end of 1819, at 73 years of age.” He painted it in 1820.1 In Goya’s previous representations of physicians, he had portrayed them as inept and dishonest.1 However, his near-fatal illness in 1819 stimulated the artist’s great gratitude toward his doctor, Eugenio García Arrieta.

Arrieta is shown supporting an ill Goya and offering a glass of what may be medicine. The doctor’s skin is warm and ruddy in comparison to Goya’s shiny, pale, bluish complexion. The tilt of his patient’s head, open mouth and half-open eyes illustrate clearly a condition of severe weakness. His hands are clenched in evident pain. Even the color of Goya’s robe and blanket is muted in comparison to the rich green of Arrieta’s coat and bright red of his lips. Arrieta’s gentle touch is apparent in his left hand, which keeps Goya upright. The proximity of Arrieta’s face and body to Goya’s illustrates great empathy. It also shows that Goya’s illness causes the doctor no fear or disgust. In contrast, three figures stand farther away. Their faces appear ominous in the darkness.

The painting Goya created in thanks is reminiscent of the religious ex-voto portraits that were offered to saints as expressions of devotion or gratitude.2(p356) Some have also compared its composition, depicting Arrieta holding the ill Goya, to that of a pietà, in which the Virgin Mary traditionally holds the dead Jesus Christ.2 Goya’s painting is also allegorical in that the other figures in the scene, one of whom is robed and priest-like, have been relegated to the darkness whereas Arrieta, a physician and man of science, sits in the foreground.1 This may reflect the gradual rise of the Age of Enlightenment and decline of the Spanish Inquisition.

Francisco de Goya is considered the most important Spanish artist of the late eighteenth and early nineteenth centuries, as well as one of the last Old Master painters.3 He painted for over 50 years and created several hundred paintings, which reflected the political and social changes he observed over the course of his career, including the Enlightenment, the French occupation of Spain by Napoleon, the Spanish Inquisition, and the Peninsular War.3

Goya’s life is punctuated by three major periods of illness. The first took place during the winter of 1792-1793 and lasted several months.3 This episode left him with permanent deafness, transient vision loss and paralysis, as well as severe depression.1 The cause of his illness is a continuing mystery. Scholars have suggested various diagnoses on the basis of Goya’s symptoms. The differential diagnosis produced so far includes: late acquired syphilis (which would have caused his behavioral changes and his wife’s multiple failed pregnancies), Vogt-Koyanagi-Harada disease (a rare autoimmune disease with multisystem manifestations), lead toxicity (from the lead in his paints), malaria (which was endemic in Spain at the time), quinine toxicity (from the quinine bark he may have chewed to treat malaria), and many others.3 Each has significant reasons they are or are not possible, so the subject is still debated. No matter the cause, Goya’s deafness had the most significant impact on his life.3 He resigned from teaching at the Academy of San Fernando, and the subjects of his paintings became significantly darker and more morbid.3

The second major bout of illness was his 1819 episode, which occurred during a yellow-fever-like epidemic devastating Spain.3 The details of his sickness and treatment are unknown, but after this period, Goya became even more withdrawn.3 His paintings again became eerie, horrific.3 The third episode of illness in his life was his last, when in 1825 he developed bladder disease and a tumor in the perineum.3 He died in 1828 at the age of 82.3


Trang Diem would like to thank Dr. W. Bruce Fye, Professor of Medicine and Professor of History of Medicine at Mayo Clinic, and Ms. Melissa Rethlefsen, former Librarian and Assistant Professor of Medical Education at Mayo Clinic Learning Resource Center, for their thoughtful review of this paper and valuable guidance. She would also like to thank Dr. Johanna Rian and Dr. Paul Scanlon, Coordinator and Chair of Mayo Clinic Center for Humanities in Medicine respectively, for their continued support and encouragement.


  1. Casey LL. Goya: “In sickness and in health.” International Journal of Surgery 2006;4: 66-72.
  2. Mathiasen H. “Empathic Art: Goya and Dr. Arrieta.” The American Journal of Medicine 2008;121: 355-356.
  3. Ravin JG, Ravin TB. “What Ailed Goya?” Survey of Opthalmology 1999;44: 163-170.

TRANG NGOC DIEM VU, BS, is a second-year medical student with an interest in the medical humanities. She is pursuing an MD at Mayo Medical School and plans to graduate in 2016. She completed a BS in molecular & cellular biology with a minor in writing seminars at Johns Hopkins University, Class of 2012.

Summer 2014



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