Isenheim Altarpiece: A Portrait of Agony; a Message of Hope


I cannot imagine caring for patients with “St. Anthony’s Fire” in the 1500s.  Our medicines have come along ways and palliative care nurses are by the sides of those facing unremitting symptoms, torment, and anguish.   Nevertheless, patients with serious conditions are faced with their own mortality and the instinctual drive to defy our destiny with ashes.

When to fight on, what medicines to accept, when to let go, how to reach an integrated decision reflective of the self, of the spirit, and of your loved ones amidst uncertain medical prognosis.

The painting above captures the agony of the crucifixion, the friends and family by Christ side, saints on the side panels, and the release from earthly suffering on the bottom panel. It served the patients at the Monastery of St. Anthony four centuries ago who were facing certain death by providing hope and faith.

Yesterday I prayed the twenty-third psalm in a hospital chapel for a patient I did not know.  The chapel was far removed from patient care and barely adorned.  A janitor in the backround drove a wax floor cleaner maintaining the appearance of cleanliness and order in the corridors of acute care.  The sanitization of death, illness, and suffering somehow only increases suffering.

A corridor or two away my wife, a palliative care nurse, spent two hours that evening being present to acknowledge agony, clarify prognosis, and guide a family to reach an integrated decision.    Some recover from the immediate health crisis, some postpone its inevitable outcome, and some prepare for the end without further recourse.  Theresa brings the artwork to life in practice despite its absence in the hospital santuary.  It is a calling.  We all have one.  What is yours?

In the artwork above is something for each of these trajectories.  None of us escape this earth without suffering and without dying. If we are lucky we will be connected to life’s depth of mystery and spirituality.  If we are lucky, when we are facing our own mortality, we will have an angel of mercy at our side guiding our decisions, alleviating our suffering where possible, and sharing our pain.  If we are lucky this will provide us enough peace to face whatever crosses we have to bear today and the remaining days we have on earth.

Post inspired by Theresa’s work and NY Times article on Altarpiece.    References below.



A psalm of David.

 The Lord is my shepherd, I lack nothing.
     He makes me lie down in green pastures,
he leads me beside quiet waters,
     he refreshes my soul.
He guides me along the right paths
    for his name’s sake.
 Even though I walk
    through the darkest valley,[a]
I will fear no evil,
    for you are with me;
your rod and your staff,
    they comfort me.

 You prepare a table before me
    in the presence of my enemies.
You anoint my head with oil;
    my cup overflows.
 Surely your goodness and love will follow me
    all the days of my life,
and I will dwell in the house of the Lord

“Sculpted by Niclaus of Haguenau and painted by Matthias Grünewald in the 1550s, the altarpiece was made for the Monastery of St. Anthony in Isenheim, which had a hospital that treated, among other ailments, the skin disease known as St. Anthony’s fire. (Today the altarpiece is on view at the Musée Unterlinden in France.)

The altarpiece, Mr. Atkins said, spoke to both the hospital’s often terminally ill patients and those who treated them. On the panels, Jesus’s Crucifixion is depicted as especially grisly. His skin is riddled with blemishes, and his fingers are grotesquely curled. On the ground, witnesses to his death are anguished.

“Many of us can relate to this on an individual level, or knowing someone who has fallen ill and had to grapple with all the pain,” Mr. Atkins said.

But the altarpiece also shows Jesus’s ascension into heaven. And therein lies salvation. “The pain is temporary,” Mr. Atkins said. “There is release.”

NYT article with illustration commentary:

History of the art piece:

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