Thomas Eakins' The Agnew Clinic

19th Century Masterwork of American Realism

Oct 25, 2009 Meg Nola

Well-known for his 1875 The Gross Clinic, Thomas Eakins later painted The Agnew Clinic, another medical portrait which forthrightly depicted the trauma of breast cancer.

Fourteen years after Thomas Eakins finished his controversial medically-themed 1875 painting The Gross Clinic, he was commissioned to produce a work commemorating the retirement of Philadelphia surgeon David Hayes Agnew. Agnew had had a long and distinguished career, was a University of Pennsylvania School of Medicine instructor, and had even presided over efforts to save the life of President James Garfield following a fatal assassination attempt in 1881.

Agnew and Eakins

Rather than opting for a formal portrait of Dr. Agnew, Eakins chose to portray him in action while overseeing the removal of a cancerous breast from an unconscious female patient. Beyond the painting’s focal point of the operation itself, Agnew’s students were included as figures observing in an amphitheater classroom setting.

Up until 1886, Eakins had been Director of and a popular teacher at Philadelphia’s Pennsylvania Academy of the Fine Arts. He was passionate about working from real life studies and an expert in anatomical depictions of human and animal figures. Eakins’ tribute to Dr. Agnew was the largest painting he had ever attempted and shows the changes for the better in surgery that had transpired since Eakins had finished The Gross Clinic.

While Dr. Gross and his assistants wear everyday clothing during their operation, Dr. Agnew and his staff are in uniforms or surgical gowns. The Agnew Clinic uses a clearer, lighter palette and has a less claustrophobic composition, thereby giving it a more hygienic appearance. Masks and gloves, however, were apparently not yet standard surgical garb in 1889.

Nurse Mary Clymer

Eakins occasionally liked to put himself in his paintings, and his minimized figure can be seen at the operating room doorway as he listens to someone whispering by his side. The inclusion of Eakins was actually done by Eakins’ wife, Susan Macdowell Eakins, who had been his former student and was an artist in her own right. Beyond this subtle feminine input, the obvious female presence of a nurse is a striking note in The Agnew Clinic. The woman in the painting was Philadelphia nurse Mary Clymer, who stands with almost military precision. There are no female medical students in the observing group.

Nurse Clymer appears torn between her need for detachment and her empathy for the woman lying before her. Breast cancer surgery was not often successful in removing all traces of the disease at the time, and some patients literally bled to death following mastectomies. Self-examination was no doubt considered immodest, thereby making early detection rare, while additional treatments like chemotherapy, radiation or nutritional healing were also not yet available.

Perceptions of the Work

Like Eakins’ The Gross Clinic, The Agnew Clinic was strong viewing for people of the day. In the case of The Gross Clinic, however, objections seemed to center around the realistic gore and intensity of the operation. In The Agnew Clinic, a disease that was mostly kept private and involved female sexual organs was now being put on public display.

Mary Clymer’s notes detail how that during the actual surgery, the patient’s untouched breast was hidden under a sheet. Eakins’ decision to bare the breast in his painting could have been linked to his love of the human body and contempt for excessive modesty, or it may have been to provide a dramatic effect. Had Eakins been extremely progressive, he might have felt that to cover the woman’s other breast could be perceived as a diminishment, and yet another effort to keep the then-perception of breast cancer hidden and even shameful.

Legacy

In a contrast of personalities, in 1871 Dr. Agnew reportedly declined to give a lecture to female medical students because he did not think that women belonged in the medical profession. He asserted that women were better-suited to domestic and artistic pursuits, and that the more a woman knew, "the worse off she was."

Thomas Eakins, on the other hand, challenged his female students to learn as much as the men in the class, and he was eventually fired from the Pennsylvania Academy for allowing said females to view a fully naked male model — instead of a model with a loincloth discreetly covering his private parts. Eakins had various other overzealous indiscretions to back up his dismissal, however, and his attitudes towards both sexes were complex and most likely confusing even to himself.

In the long run, though, Eakins’ desire for truth in his teachings and in such works as The Agnew Clinic appear to have moved perceptions forward, and to have stripped away sheets and loincloths to reveal what should never have been denied.

Sources

• Eakins Revealed: The Secret Life of An American Artist (Henry Adams -- Oxford University Press, 2005)
• Penn in the 19th Century: The Medical Class of 1889 -- Thomas Eakins’ The Agnew Clinic

The copyright of the article Thomas Eakins' The Agnew Clinic in Modern Art History is owned by Meg Nola. Permission to republish Thomas Eakins' The Agnew Clinic in print or online must be granted by the author in writing.

The Agnew Clinic (Thos. Eakins, 1889)

Self-Portrait, 1902 (Thos. Eakins)