Hektoen International

A Journal of Medical Humanities

Ellen Powell Tiberino’s The Operation

Cody Ritz
Philadelphia, Pennsylvania, United States

The Operation (1980), Ellen Powell Tiberino. Philadelphia Museum of Art: Purchased with the Julius Bloch Memorial Fund created by Benjamin D. Bernstein, 1990, 1990-116-1. Permission obtained through the Tiberino estate.

In the graphite drawing by the late Ellen Powell Tiberino titled The Operation (1980), a tangled chaos emanates from an operating table surrounded by medical professionals of varying expressions—the two closest of whom hunch over the mess of contraptions and viscera with claw-like hands. Another healthcare worker stares directly at the viewer with a horrifically wide-eyed grin. Such a character possesses some uncanny parallels with the figure of the internet’s infamous “Momo Challenge,”1 featuring an eerie sculpture with an ambiguous nature. In addition, the grim reaper in the corner serves as a reminder that one can merely delay the inevitable.

The Operation emerged in the latter stage of Tiberino’s life during her fourteen-year struggle with cancer.2 The drawing provokes a purposeful sense of discomfort in the viewer, and it also reflects both a societal perception of cancer and the quality of care offered to Tiberino.

Discomfort as a tool for contemplation

Discomfort in art has a purpose. Tiberino reportedly would often say, “I take life, and life is not always beautiful,” when choosing subjects for her work. Ellen Powell Tiberino is not the only visual artist who was willing to artistically document her struggles with illness. Frida Kahlo built a reputation on this characteristic of her paintings. Artworks such as Broken Column (1944) illustrate Kahlo’s difficulties with chronic pain after a serious bus accident at eighteen years of age.3 Similarly, Tiberino’s The Operation invites the viewer to take part in an unsettling experience during her struggle with cancer. While many of the worrisome characters in The Operation add to the level of discomfort, much of the work’s uncanniness derives from the way it depicts an operating room—a familiar sight for medical professionals—in a rather unfamiliar manner. It is reminiscent of a nightmarish dream state where elements of reality are seamlessly intertwined with fictional embodiments of one’s worst fears. Through this process, the drawing takes the careful observer into the artist’s state-of-mind as she underwent the rigors of cancer treatment. The discomfort elicited by this artwork, although quite jarring, is purposeful because it grabs the viewer’s attention and challenges them to view the healthcare setting anew.

For medical providers, sitting with discomfort is an important skill to develop, as it can help construct bridges of compassion, without which, medicine is “mere technology, curing without healing.”4 By carefully navigating uncomfortable situations and developing compassion for patients in this way, providers have the opportunity to challenge their perceptions and subsequently transform their view of self, others, and the world at large.3 For these reasons, the discomfort produced by The Operation is a powerful tool that facilitates contemplation and encourages healthcare providers to step outside the “automaticity”3 of their practice.

A reflection of both illness and healthcare

A patient’s healthcare experience is highly subjective, and personal perceptions are influenced by factors such as one’s degree of sickness, social support, relationships with providers, access to care, etc. When combined, these factors can tailor an individual story that is difficult to replicate. Therefore, one’s personal understanding of disease has been characterized as a “messy assemblage of biomedical knowledge, cultural metaphors, and past and current lived illness experience.”5 Patient-created art reflects the social constructions surrounding their disease at the time.5 In Tiberino’s case, her work encourages the viewer to imagine the harrows of a cancer operation in the United States during the 1970s. Despite how much the field of medicine’s understanding of the disease has progressed since that time, the word “cancer” still connotes fear and uncertainty even today. While few people experience such a burdensome diagnosis, the true horror of that reality is nonetheless conveyed in Tiberino’s representation. Her sketch reflects the fears that many people possess for such a formidable disease. Consequently, it is vital for healthcare providers to remain aware of these fears since the practice of medicine does not exist separate from its societal context.

In addition to what The Operation reveals about social constructions related to cancer, it also hints at some shortcomings concerning the quality of care experienced by the artist herself. Such a negative portrayal of a healthcare setting begs the question: Is there anything that could have influenced Tiberino to depict a more hopeful image? Her distressing interpretation of an operating room allows the viewer to partake in a “critically reflective”3 examination of her medical care. Perhaps, hidden behind the chaos of Tiberino’s scene, there stands a reflection of a flawed tendency of healthcare providers to treat an illness instead of a patient, without regard for quality of life.


Ellen Powell Tiberino’s The Operation is a powerful example of an artist’s ability to communicate the effects of illness through their work. Her use of a visual medium is an almost “universal language”6 that conveys the gravity of her experience when words alone would not suffice. When people are willing to sit with the discomfort of The Operation—and that of other similar works of art—they can gain powerful insight into the troubles of navigating one’s own illness and advocate for a standard of patient-centered care that is maximally attuned to an individual’s needs.


  1. Herrman J. Momo Is as Real as We’ve Made Her. The New York Times. https://www.nytimes.com/2019/03/02/style/momo-mania-hoax.html. Published March 2, 2019. Accessed August 28, 2021.
  2. The Operation. Accessed August 28, 2021. https://philamuseum.org/collection/object/85775
  3. Kumagai AK, Wear D. “Making Strange”: A Role for the Humanities in Medical Education. Academic Medicine. 2014;89(7):973-977. doi:10.1097/ACM.0000000000000269
  4. Edmund D. Pellegrino. To Look Feelingly-the Affinities of Medicine and Literature. Literature and Medicine. 1982;1(1):19-23. doi:10.1353/lm.2011.0214
  5. Guillemin M. Embodying Heart Disease Through Drawings. Health (London). 2004;8(2):223-239. doi:10.1177/1363459304041071
  6. Jacobs J. Creative Health Communication: Art Solutions for Unequal Medical Care. [Honors Thesis Science and Society]. Providence, RI: Brown University; 2014.

CODY RITZ is a graduate of Brigham Young University and a second-year medical student at Drexel University College of Medicine. While currently enrolled in his school’s humanities scholar program, he is interested in the interdisciplinary aspects of healthcare and particularly enjoys the intersection between visual art and medicine. His other interests include emergency medicine, wilderness medicine, global health, health policy, and health equity.

Highlighted in Frontispiece Volume 14, Issue 2 – Spring 2022

Fall 2021




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