Thomas Eakins – The Gross Clinic

Thomas Eakins, Portrait of Dr. Samuel D. Gross (The Gross Clinic), 1875, oil on canvas, Philadelphia Museum of Art

The central figure in this, one of the most celebrated realist paintings in all nineteenth century American art, is Dr. Samuel Gross, the illustrious trauma surgeon, seen here presiding over a thigh debridement operation - the excision of diseased tissue and bone. He stands in the well of a lecture hall amphitheatre with his students ranged behind him while his five assistants, including one hidden from view directly behind Gross, sit in close attendance, equipped with retractors and other instruments. As the eminent professor, Gross is depicted spotlit, as if he were chosen by the heavens above, so that the seriousness and gravity of his endeavour seem to be highlighted as much as his person, his receding brow and seemingly intelligence-frizzled hair and side-whiskers forming a halo around his head. His grisly hand and scalpel are held casually as he leans on the table readying himself to make an authoritative observation to his audience, but which serve to cause the only female figure in the painting (identified by scholars as the patient’s mother), to recoil in horror. The nominative determinism in Dr. Gross’s name is evident in the repellent incision and bloodletting that confronts us.

This was a radical painting for the period. Formal portraits of the male great and the good would usually show their subjects seated, wearing thoughtful expressions, sometimes with a hand tucked inside a waistcoat (the hidden hand of unruffled but imperious leadership), sometimes with books or other papers nearby to indicate erudition. Power, wealth, or other forms of prerogative would be thus easily inferred in the mind of the viewer. But here, that sense of dominion is portrayed much more directly and viscerally. Gross is shown literally hands-on, pictured in the act of doing the very thing for which he had become most respected, rather than sat at rest in retirement.

The artist is fully aware of the surgeon-lecturer’s own sense of single-minded yet egotistical theatricality. By this time seventy years old, this ‘cutter’ is shown as forbiddingly haughty and detached from the fact that he has another’s life in his hands. What matters to Gross is not the patient’s humanity – his or her character, emotions, or relationships but only the orthopaedic operation he is performing on him. In fact, that patient, with even his face obscured by a chloroform-infused cloth, is anonymised, a radically foreshortened body lying on its side with the backside pointed towards the viewer, a mere supporting player to the leading man. The one element of piteous identity are the grey socks that cover his feet. Meanwhile Gross is shown as aloof, someone who would doubtless feel disdainful of the bathetic hosiery detail noticed by this viewer. It may sound oxymoronic, but what Eakins captures is Gross’s emotionless ostentation. The great doctor is shown to be cognizant of the respect that is his due as one of the foremost medical practitioners of his age, having almost single-handedly transformed the reputation of surgery from the quasi-butchery of last resort amputation into much more precise, scientific, and refined procedures. Eakins’s portrait of Gross is thus less like the conventional depiction of figures of importance than a psychological representation of groundbreaking medical advancement, personified.

When the work was exhibited in New York a few years later, critics were shocked by what they perceived as Eakins’ sickening rendition of the gore in view on this operating table. They judged it unnecessarily real and the painter to be unduly sensationalist in his determination to reveal proceedings to which others might prefer to turn a blind eye. The painting had been rejected for exhibition in Philadelphia’s centennial world’s fair in 1876 and this wasn’t to be the only occasion on which Eakins would court controversy. As an art teacher he would later cause scandal for perceived permissiveness in allowing his female students equal access to nude male models in their life drawing classes, a decision which was to lead in time to his forced resignation. But this incident is illuminating of Eakins’ uncompromising commitment to the critical business of looking and in some ways, this is also the theme of this painting. It tells us that sometimes, you must resist the instinct to turn away and must force yourself to look, even at the cost of revulsion. Only that way will scientific and artistic progress be made. Eakins clearly sees an equivalence between artist and surgeon and that bloody scalpel might stand in for the artist’s own paintbrush. In fact, the figure on the far right leaning forward with pen or pencil in hand and staring intently, the only figure in the painting with the whites of the eyes visible, is thought to be Eakins himself, taking it all in, observing unflinchingly. The artist has signed his name on the end of the operating table, as if he takes ownership of it and in repudiation of critical squeamishness.

The weight and seriousness of the event depicted is underlined by the largely monochrome palette. Gross cuts (no pun intended) an imposing figure in his sombre velvet-collared frock coat, black bow tie, waistcoat, and wing collared shirt while all the other figures in the painting, including the patient’s mother prematurely wearing funereal black bombazine and a veil, seem similarly colourless in the shadows. Against this sobriety the blood stands out graphically and revoltingly, but I also like how the red lighting of the tunnel entrance is suggestive of a body’s opening after incision – what lies inside is mysterious, the preserve of that priesthood of doctors, anatomists, and medical students.

Eakins took a keen interest in surgery and at one time had considered a medical career for himself. This had prompted him to attend classes, including lectures on anatomy and dissection. Were these lively affairs? My guess, judging by how he depicts the demeanour of many of the students attending this class is that they were not. Despite the histrionics of the mother, most of those attending seem bored, a number of them with heads resting on hands while others look on as if they have seen and heard it all before. A stenographer, dutifully records Gross’s commentary, while two further figures stand in attendance in the tunnel entrance but lean against the wall insouciantly, as observers but not as participants. All of this strikes a discordant note. A man’s life is in the balance, and while the mother and Eakins seem more than aware of this, and while those assisting the operation are clearly fully engaged, everyone else seems remarkably unconcerned. Could it be that Gross evinced a phlegmatic detachment in his clinic and his acolytes saw fit to emulate the great man’s comportment?

Some art historians have read this painting in Freudian terms, with the figure of Gross as a father figure of fear and rivalry for the artist and the operation itself as a playing out of castration anxiety. Others view the painting through the lens of sexuality and in the context of Eakins’ presumed preferences, this is a painting that depicts a fraternity of medical and homosocial if not homosexual desire. Neither of these readings is entirely convincing but it is enough for me that Eakins has created a portrait of self-referential complexity that celebrates compassionately the discipline involved in undaunted observation and practice.