Feature Christmas 2012: Yesterday’s World

Barbara Hepworth’s hospital drawings

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8529 (Published 19 December 2012) Cite this as: BMJ 2012;345:e8529
  1. Richard Cork, art critic, historian, broadcaster, and curator
  1. richardcork{at}hotmail.com

Nobody could have guessed that Barbara Hepworth’s contact with a surgeon would suddenly produce, after the second world war, an outstanding series of drawings inspired by hospital operations.1 She was, after all, renowned for her controversial achievements as an abstract sculptor. So why did she start work on these powerful images of surgeons, while tirelessly visiting operating theatres in Exeter and London as her fascination with the subject deepened?

Hepworth’s involvement with operations began in 1944, when her young daughter Sarah had osteomyelitis. After Sarah was bandaged “in plaster of Paris from head to toe,” Hepworth’s anxiety became intense. But even then, she was fascinated enough to notice that “the moulding of plaster jackets . . . was very near to my own profession.” As Sarah’s illness became protracted, Hepworth and her husband Ben Nicholson found the medical bills ever more daunting. Yet she received heartwarming sympathy and support from the surgeon Norman Capener. Unlike so many British art lovers of that period, he relished modern art at its most adventurous. Capener was an amateur painter, and was particularly fascinated by the mutually rewarding relation between avant-garde art and music. He told Nicholson that Hepworth’s sculpture had “a very striking similarity to Bach’s more abstract work.” Capener began purchasing her art, and he also backed up their friendship by waiving his surgeon’s fee.

In the summer of 1947, Capener sensed that Hepworth’s central involvement with the structure of the human body might mean that she would find stimulus in observing an operation. He had transferred the ailing Sarah from a modest Cornish hospital, near Hepworth’s home in St Ives, to the far larger Princess Elizabeth Orthopaedic Hospital in Exeter. Capener seized his moment when he stayed in St Ives to recover from jaundice. Visiting Hepworth, he asked her if she would like to attend an operation in Exeter and “see directly the work of surgeons in action.”

At first, Hepworth reacted with horror and denounced his suggestion as “a grim idea.” Sarah’s illness still haunted her, and she turned down Capener’s proposal. But then, after making clear that observing “any element of catastrophe would be impossible for me,” Hepworth decided to push aside her misgivings, take up Capener’s offer, and scrutinise an operation in Exeter.

The experience was so compelling that Hepworth went on to observe further operations at the National Orthopaedic Hospital in London and the London Clinic. Having produced her first hospital drawing in November 1947, Hepworth devoted a prodigious amount of her energy and imagination to make nearly 80 drawings over the next couple of years. By that time, the National Health Service had been created, and her strong support for this crucial postwar initiative must have added to the extraordinary intensity of her hospital images.

Over two decades earlier, the young Hepworth had made her first contribution to art in a medical context, while still a student at the Royal College of Art in London. As an entry for a scholarship to study in Rome, she made a proposal for a “panel sculpture” above the main entrance of a hospital. The traditional style she adopted bore no relation to her subsequent work as a highly audacious artist, who shared Henry Moore’s determination to revitalise British sculpture. Hepworth became one of few women to achieve a prominent position as a modernist during the interwar period. And now, in the late 1940s, her involvement with surgical operations proved that drawing could have a major role in her mature output.

Hepworth visited hospitals armed with a pen, pencil, and sterilised pad. They enabled her to make swift sketches and notes while scrutinising the surgeons as they went through the various stages of intricate bone operations. All her initial misgivings disappeared, and she grew captivated by the spectacle unfolding in front of her. “From the moment when I entered the operating theatre,” she remembered, “I became completely absorbed by two things.” The first thing was “the extraordinary beauty of purpose and coordination between human beings all dedicated to the saving of life, and the way that unity of idea and purpose dictated a perfection of concentration, movement, and gesture.” Secondly, she was awed “by the way this special grace (grace of mind and body) induced a spontaneous space composition, an articulated and animated kind of abstract sculpture very close to what I had been seeking in my own work.”

All these drawings show Hepworth’s willingness to simplify the surgeons and patients alike. Their bodies are purged of all unnecessary detail and reduced to essential forms. But this search for minimal reduction does not mean that Hepworth lost sight of communicating the fundamental meaning inherent in the medical scenes she had studied at first hand. In her exhibition at The Hepworth Wakefield, Wakefield, the expertise and dedication of the surgeons is clearly evident.

Hepworth takes her place in a long and distinguished tradition of great artists who became enthralled by the skill and commitment of medical practitioners. In my book, The Healing Presence of Art, I single out doctors’ portraits by painters as eminent as Francisco de Goya, Vincent Van Gogh, Henri de Toulouse-Lautrec, and Frida Kahlo.2 In 1820, Goya painted a moving Self Portrait with Doctor Arrieta.3 4 Here the stricken, 73 year old Goya is supported by a physician who clasps him while offering a lifesaving glass of medicine. A similar respect distinguishes Van Gogh’s Portrait of Trabuc, the head attendant at the Saint-Remy mental home where the distraught artist was cared for in 1889-90. Trabuc looks stern, and yet Van Gogh explained that “he is a man who has seen an enormous amount of suffering and death, and there is a sort of contemplative calm in his face.”

Only one year later, in Paris, Toulouse-Lautrec became obsessed by the virtuoso operations carried out in the Hopital Saint-Louis by the celebrated Dr Jules-Emile Pean. “If I were not a painter, I would like to be a doctor,” Toulouse-Lautrec often declared. And he made many incisive portraits of Pean who, like Norman Capener, harboured dreams of becoming a painter. Then, in 1951, Frida Kahlo painted an iconic portrait of herself in a wheelchair with Dr Juan Farill, an outstanding Mexican surgeon who operated on her severely damaged spinal column.5 She called him “cutie,” but his face has a god-like character in Kahlo’s reverential painting.

Although Barbara Hepworth had a similar affection for Capener as Kahlo did for Farill, in most of her hospital drawings, the surgeons are masked and difficult to identify. Fascinated by every stage of the surgical process, she used a mixture of pastel, gesso, pencil, and oil paint to define the moment of preparation in a masterly drawing called Prevision. Here, the eyes of the surgeon have a piercing probity as he gazes down at the prone, vulnerable body we cannot see. But the focus of the drawing rests on his two immense hands, one of which is precisely adjusting the sleeve of his garment. The elongated fingers and thumbs are at once strong and delicate. Hepworth almost seems to carve them in space.

Sometimes, she even used a razor blade to scratch the surface of the drawings, thereby giving them an even greater sense of etched urgency. The scratching also conveys the nervous energy experienced by the surgeon, as he braces himself for taking on the full, burdensome responsibility involved in wielding the knife. In a drawing called Prelude II (fig 1), which includes as many as seven figures, Hepworth might be the masked woman who stands on the far left of the scene, her clasped hands possibly hiding a sketchpad. She could easily be praying, and the other figures gather round the patient’s bed, like priests enacting a religious ritual. The surgeon at the centre stares at his own upraised hand, as if appraising its readiness for the task ahead. And another masked participant holds a large oval light, directing it carefully down towards the crucial place where its brightness will be needed.

The longer we look at Hepworth’s images, the more we realise just how appropriate the phrase “hospital theatre” really is. All the participants seem to be caught up in a life-or-death drama, and we gaze at them as avidly as an audience watching a mesmeric play being performed on a stage. But Hepworth also makes us aware of what Stanley Spencer described as the “stillness in the theatre.” After serving at Beaufort War Hospital in Bristol, a former lunatic asylum taken over by the army for war casualties, Spencer announced in 1916 that he wanted to paint “a fresco of an operation” catching the “classical” quality of the scene. He never achieved his aim, and yet Hepworth’s finest drawings have the aura of ancient frescoes discovered on the walls of a temple dedicated to healing.

She was particularly fascinated by the ear fenestration operations carried out by the prominent London Clinic surgeon ER Garnett Passe, accompanied by his assistant Dr John Seymour and the theatre sister Margaret Moir. The surgeon uses a hammer to gain access to the inner ear, and Hepworth must have been especially intrigued by this connection with the sculptor’s hammer, which she deployed to chisel into stone. Moir, who later became Hepworth’s secretary, described how Hepworth “came to the London Clinic on several occasions in the space of two or three weeks, each time a fenestration operation was being performed . . . She did brief sketches during these visits, at all stages of the operation.” The only surviving sketchbook with Hepworth’s hospital drawings relates to the “fenestration of the ear” operations that she witnessed between April and May 1948. The sketches are labelled with colour references to help Hepworth embark on her elaborate drawings back in the studio, and she also jotted down notes like “magnifying glasses” to help her identify the crucial optical devices employed during surgery.

No such notes are permitted to interfere with the eloquent effect of the figures in Hepworth’s large, finished compositions. Drawings as powerful as Tibia Graft (fig 2), or Concentration of Hands II (fig 3), take us right to the centre of the hushed and attentive atmosphere in the operating theatre. She brought a seasoned carver’s knowledge to the task of conveying surgical finesse, and Hepworth was awed by the activities she observed. “A particularly beautiful example of the difference between physical and spiritual animation can be observed in a delicate operation on the human hand by a great surgeon,” she explained. “The anatomy of the unconscious hand exposed and manipulated by the conscious hand with the scalpel, expresses vividly the creative inspiration of superb coordination in contrast to the unconscious mechanism. The basic tenderness of the large and small form, or mother and child, proclaims a rhythm of composition which is in contrast to the slapping and pushing of tired mother and frustrated child through faults in our way of living and unresolved social conditions.”

Hepworth’s revealing account, with its emphasis on the relationship between a mother and child, suggests that she was guided throughout the hospital drawings by the strength of her love for her own daughter Sarah. The key words are “basic tenderness.” For Hepworth was able to invest the finest of these images with a heartfelt belief in the profound significance of compassionate and delicate surgeons, as they devote themselves to the challenge of life saving in the luminous hospital chamber.


Cite this as: BMJ 2012;345:e8529


  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • An exhibition of Hepworth’s hospital drawings continues at The Hepworth Wakefield, Wakefield, until 3 February 2013, before travelling to the Pallant House Gallery, Chichester (16 February to 2 June 2013), and the Mascalls Gallery, Kent (14 June to 24 August 2013).

  • Provenance and peer review: Commissioned; not externally peer reviewed.