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Academic Medicine:
doi: 10.1097/01.ACM.0000442620.77761.88
Medicine and the Arts

Commentary on Kathrin, a portrait by Thomas Eakins

Tomasic, Veronica Maria PhD, JD

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Dr. Tomasic practices law in New Haven, Connecticut. She is a scholar of literature and painting, and she is a member of Yale’s Interdisciplinary Center for Bioethics; e-mail:

We can learn from a painting that it is possible to grasp the significance of a person’s entire life in the space of an instant. Thomas Eakins’ portrait of a young woman named Kathrin is such a painting.

Considered one of America’s great realist painters, Eakins (1844–1916) is well known for his portraits of esteemed members of Philadelphia’s community. The Gross Clinic (1875) and The Agnew Clinic (1889) are massive oil paintings portraying, respectively, Dr. Gross and Dr. Agnew, renowned surgeons of their day. In the portraits, the figures of these men tower over the viewer and depict, through their bearing and through their particular gestures as surgeons in the operating theater, a commanding presence. The portraits represent the surgeons as having mastered the human body and human emotion by means of science, technique, and the art of medicine.

Kathrin (1872), by contrast, is a portrait of a young woman lost in her thoughts in a quiet, intensely private, domestic moment. The portrait is especially poignant because Kathrin, who was 23 when it was painted and soon to be engaged to Eakins, died seven years later of meningitis.

So what does this painting tell us about Kathrin, or, rather, what can it tell us since, as a well-brought-up young lady of that era, her accomplishments would have been limited to the domestic sphere, unlike those of Drs. Gross and Agnew, her famous counterparts? Almost immediately her portrait conveys that Eakins may have known that her life would be short-lived. He painted her out of direct light, in the shadowed recess of a room. (The room no doubt one in her family home in Philadelphia.) Behind her, almost coffin-like, looms a large bookcase and cupboard. The effect is sepulchral. Eakins was an acute observer of the human body and had once thought of becoming a surgeon. Perhaps he observed in Kathrin a fragility which led him to realize that she would not develop into full womanhood.

That she plays wistfully with a kitten accentuates the idea that she will not have the opportunity to grow up. Playing reminds us of her childhood, her girlhood. The kitten’s position in her lap hints at her nascent sexuality, but the sense of the painting is that she will never hold her own child in her arms. In this painting she seems to linger in the experience of childhood, of games and fantasy. She can only imagine adulthood, marriage, and motherhood.

Drs. Gross and Agnew are figures whose grand reputation pervaded not only the operating theater within which Eakins painted them but probably all of Philadelphia society as well. By contrast, Kathrin retreats into the darkness of the room she sits in, almost as if she is retreating from life itself. Can we say that the surgeons were accomplished because of their success in the world, and she was not, because she died young, and while alive, likely spent most of her time at home? I think not.

Contemplating this painting, many are reminded of Henry James’ Isabel Archer, his tremendously appealing protagonist in The Portrait of a Lady (1881). Isabel’s story begins as she sits reading in a “joyless”1(p20) room “grown sallow with time”1(p18), in an old house in Albany. Isabel is destined to live and die not far from this place, but her aunt rescues her and takes her to Europe so that she might “introduce [Isabel] to the world.”1(p36) In his preface to the novel, James explains that he conceived of Isabel because he had an image in mind of a “certain young woman affronting her destiny.”1(pxi) He writes that girls such as Isabel “insist on mattering.”1(pxii) He explains, using the term “frail vessel” borrowed from George Eliot, that each of these girls, each “frail vessel … has … possibilities of importance to itself, possibilities which permit of treatment and in fact peculiarly require it from the moment they are considered at all.”1(pxiii) In other words, the modest life of a young, sheltered girl may contain the seeds, the “possibilities of importance,” which, in imagination, can equal or surpass the manifestations of relevance displayed by those who have worked and gained fame in their lives.

I was recently reminded of Kathrin when a client of mine, of whom I knew little, died relatively anonymously in her hospital room while machines beeped, chaos ensued in the hallway, and staff began and ended their shifts. The medical considerations, the checklist involved with preparing to remove her breathing tube (which would be followed, soon after, by her death), marked her last hours. Like Kathrin, my client’s contributions to her community may have been unremarkable. Certainly no family or friend who could attest to her accomplishments sat by her bedside as her life ebbed. Yet I knew that she had been a little girl, and then a young girl, and then a young woman. She had played, she had dreamt. Her possibility, encapsulated in her dreams, was her importance, her relevance.

Acknowledgments: Dr. Tomasic wishes to thank the doctors and nurses who tended to her client in her last days for their care and attention.

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1. James H The Portrait of a Lady. 1996 New York, NY Barnes & Noble Books

© 2014 by the Association of American Medical Colleges


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