Hektoen International

A Journal of Medical Humanities

The Girl with a Pearl Earring—A vanitas?

James Lindesay
Leicester, United Kingdom

Girl with a Pearl Earring. Johannes Vermeer. circa 1665. Mauritshuis. Public domain, via Wikimedia Commons.

It is a truism that you only have one opportunity to see a picture for the first time. However, in our image-saturated age, by the time you get to see a famous painting in the flesh (so to speak) you will have been so primed with reproductions, commentaries, and received opinions that these will overwhelm any direct response you might have in your few seconds of viewing the image behind its bullet-proof glass. It is no longer possible for the general public to see paintings such as the Mona Lisa. Her northern sister, Jan Vermeer’s Girl with a Pearl Earring, is fast approaching this celebrity, with the result that we are also losing the ability to see her plainly. All of which is by way of introduction to my first encounter with the Girl, and my later thoughts about her meaning.

It was forty years ago, when as a young doctor I spent time in the Netherlands acquainting myself with its art and culture. I remember her hanging in a landing in the Mauritshuis, quite famous but also quite approachable and not at all crowded, and my initial response was: she is lovely, but what is the matter with her lower lip? On that first look, I clearly saw a red area to the left side that stood out from the subtle modeling of the painted image, that to this clinician looked rather like an ulcer. In the absence of any scholarly discussion of this anomaly then or since, I presumed that this was the result of subsequent damage, overpainting, restoration, or my own imagination; however, the recent ultra-high definition images of this painting’s surface (accessible here) now enable a closer look. In particular, UV imaging indicates that this area of the image is not damaged and is as the artist created it.1 On magnification I believe it is possible to discern the rim of a lesion in the artist’s handling of the paint. If this is the case, and Vermeer is depicting pathology, what might be the cause and is there any supporting evidence?

One clear possibility is that she is being depicted as having syphilis, and that this is a first-stage chancre. Does she display any other symptoms? The sparsity of eyelashes and eyebrows has been noted in the past, and alopecia is a well-recognized symptom of secondary syphilis. Perhaps her turban, like bonnets and wigs in the eighteenth century, was also being worn to cover hair loss. Strictly speaking, chancres and alopecia are usually seen at different stages of infection with syphilis, but this painting is considered to be a tronie, that is, a constructed character rather than a portrait, so the overlay of different stages of the disease would not be an objection to this reading.

If true, what are the implications for how we should understand this painting? The vanitas, or momento mori, is a common trope in paintings of the Dutch Golden Age, a moralizing reminder of the debt owed to pleasure and the enjoyment of life. It is usually signaled by an abundance of fading flowers, rotting fruit, and infestations of insects and reptiles. If the Girl is a vanitas, then what Vermeer gives us is something much more subtle and moving: the life-limiting consequences of pleasure are written discreetly in her otherwise alluring flesh, her face turned towards us as she is swallowed by a black void, empty of comment or judgment. And what of the pearl, that other focus of our attention that hangs in the same plane as the chancre? Perhaps it is a consolation that, given time, beauty will overcome the grit and will be our memorial. If so, then the artist has achieved his aim, perhaps too successfully.


  1. https://heritagesciencejournal.springeropen.com/articles/10.1186/s40494-019-0307-5

JAMES LINDESAY, DM, FRCPsych, is Emeritus Professor of Old Age Psychiatry at the University of Leicester.

Highlighted Vignette Volume 13, Issue 2– Spring 2021

Winter 2021



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