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In 1866, the realist painter Thomas Eakins was in Paris studying at the École des Beaux-Arts. While there, he wrote to Emily Sartain, a family friend and artist who, from 1886 to 1920, would go on to become principal of what is now the Moore College of Art.

“I am proud to be a Philadelphian. … I feel 6 ft and 6 inches high whenever I only say I am an American,” he boasted.

It took some years before Philadelphia accepted and loved the artist back.

In 1870, Eakins returned to Philadelphia, where he began a career painting subjects of modern life in a straightforward manner without pretense or flourish. Establishing a studio at his family home on Mount Vernon Street, he hoped to find artistic success in Philadelphia.

But his first paintings received mixed reviews and found no buyers.

‘The Gross Clinic’

In 1875, at age 30, Eakins began work on Portrait of Dr. Samuel D. Gross (The Gross Clinic), a noncommissioned oil painting of the eminent surgeon-teacher in clinical instruction at Jefferson Medical College, where Gross was chair of surgery from 1856 to 1882.

Drawing the nude model was a central aspect of academic art training, and students were required to attend lectures on anatomy and study animal and human cadavers in dissection labs. To better his scientific realism, Eakins attended surgical demonstrations and anatomy lectures at Jefferson, and often observed surgical demonstrations by Gross.

The Gross Clinic, the 8-by-6.5-foot large oil on canvas, shows Gross and his assistants operating in their street clothes worn with long coats. The surgical tools and bandages lie unprotected on a table in the lower foreground. (Germ theory of disease was yet to become an influential factor on medical practice in the United States.)

For this first clinic portrait, Eakins uses dramatic lighting that reflects off Gross’ forehead and his extended right hand. He holds a believably bloody scalpel, emphasizing how successful surgery requires intellect and manual dexterity.

The patient is a minor; the seated woman recoiling in horror is his mother. A chloroform-soaked cloth sedates the child .

In this stopped-action moment, Gross is the commanding figure of the surgical amphitheater. While his assistants hold a retractor to keep the patient’s left thigh incision open, Gross calmly explains to his audience of students the modern practice of removing a piece of diseased bone caused by osteomyelitis.

The moment celebrates stoic men performing surgery. Gross is a heroic savior giving renewed life to a patient who didn’t have to endure a brutal amputation and will retain use of both legs.

Much of the amphitheater is cast in darkness, but a self-portrait of Eakins sits by a railing to imply authenticity of direct observation. He holds a pen or brush like Gross’ scalpel, suggesting that art making is akin to surgery.

The artwork, Eakins believed, was “very far better than anything I have ever done,” as he wrote in an 1875 letter to Earl Shinn, a Philadelphia friend who had also studied at the Ecole in Paris.

Eakins had hoped the portrait of Gross would be seen at the large international art exhibition in Memorial Hall during the 1876 Centennial Exposition in Philadelphia, and help establish his reputation.

It was rejected by the art jury, but was displayed as part of a medical exhibit in the U.S. Army Post Hospital. When the painting was exhibited later at the second annual exhibition of the Society of American Artists in New York, a New York Daily Tribune critic wrote: “It is a picture that even strong men find it difficult to look at long, if they can look at it at all.”

Given the long-term relationship of Gross with Jefferson Medical College, the artist hoped the institution would acquire the painting for its art collection. It was only in 1878 that the Alumni Association of Jefferson Medical College purchased the portrait for $200 (approximately $6,660 in today’s dollars) and presented it to the school where it remained for 129 years.

‘The Agnew Clinic’

Fourteen years later, in 1889, Eakins painted The Agnew Clinic.

By then, he had taught at PAFA, which admitted women; a rarity in its time. Eakins believed all serious art students, regardless of gender, must work from the life model and learn anatomy.

“I see no impropriety in looking at the most beautiful of nature’s work, the naked figure,” he said. His emphasis on nude life drawing and anatomical study was unsettling to Victorian propriety and his teaching methods eventually proved controversial.

The last straw came in early 1886 when Eakins was giving an anatomy lecture during which he removed a loincloth from a male model in the presence of female students. As requested by the administration, the artist, who was the academy’s director, submitted his resignation, stating: “Was ever so much smoke for so little fire?”

This was upsetting for him. In the summer of 1887, to overcome depression, Eakins made “a little trip to the West,” as he then wrote his friend and former student John Laurie Wallace, to experience “camp cure” at a ranch in the Dakota Territories.

Back in Philadelphia, Eakins received a major boost when in February 1889, he was commissioned by a group of aspiring doctors from the University of Pennsylvania School of Medicine, the nation’s oldest, to paint their retiring teacher, David Hayes Agnew, a colleague of Gross. They offered the artist $750 (approximately $27,148 in today’s dollars).

Eakins began work on The Agnew Clinic, his second clinic portrait.

Even larger, at 6 feet by 11 feet, the painting reveals some newly instituted aseptic practices. Surgeon Agnew and his team wear white gowns; sterilized instruments are placed in a covered tray. The operation has a nurse at the patient’s side, but no gloves or masks are seen being used.

Because the canvas was too large for his easel, Eakins worked on the lower sections sitting on the floor, spending long days and nights (and occasionally falling asleep) on the studio floor. The work was completed in three months.

With less dramatic lighting and looser brushstrokes than The Gross Clinic, Eakins shows Agnew in his pedagogical role operating with assistant physicians, a nurse from the HUP Training School, and more easily visible class members who are observing the surgery.

Eakins places Agnew isolated at the left, lecturing. The patient, who has had a mastectomy, is having her incision sewn as a male assistant leans over her lower body. On the far right, the artist, who in this work was painted by his wife, Susan Macdowell Eakins, observes the nude woman sedated with an ether cone.

Deemed “not cheerful for ladies to look at,” the painting is a most provocative choice of surgery for Agnew, who wasn’t a breast cancer specialist but an authority on gunshot wounds.

The Agnew Clinic was given by the medical class of 1889 to their school.

Side by side

Eakins is a distinguished presence in “A Nation of Artists,” the exhibition of 1,000-plus artworks organized by the Pennsylvania Academy of the Fine Arts and the Philadelphia Museum of Art to mark the 250th anniversary of the founding of the United States.

The Gross Clinic at PAFA and The Agnew Clinic at the PMA are part of this expansive dual-venue survey of American artworks; each is a tour de force.

The two medical portraits reveal the painter’s respect for the art of surgery, underscoring Philadelphia’s vital role in medicine and its preeminent medical schools. Anesthesia, which was newly introduced in the 19th century, is used in both operations.

Both paintings were not well received and regarded as disturbing and unsightly. But both of those large clinical portraits were exhibited together at the 1893 World’s Columbian Exposition in Chicago.

A Philadelphia Public Ledger writer complained that the “surroundings and accessories are scarcely in good taste for a public exhibition.” Another critic dismissed “the clinical horrors” as “ghastly symphonies in gore and bitumen” and mused: “To have hung the pictures at all was questionable judgment.”

Afterlives

In November 2007, Jefferson Medical College agreed to sell The Gross Clinic for the stunning sum of $68 million offered by Alice L. Walton, Walmart heiress and founder of the Crystal Bridges Museum of American Art in Bentonville, Ark.

It set off a maelstrom resulting in a spirited fundraising campaign that successfully matched her price in a few weeks, keeping the masterpiece in Philadelphia. With a few thousand donations, PAFA and the Art Museum jointly acquired the canvas.

The two institutions collaboratively share the painting on a five-year cycle; it will be at PAFA until 2031.

Unlike The Gross Clinic, Eakins was asked to paint the portrait of Agnew, creating his second clinic image and the largest canvas of his career. It was completed for presentation at the graduation ceremony that took place at the Academy of Music on May 1, 1889. Its original wood frame has a Latin inscription believed to have been carved by Eakins honoring Agnew as “the most experienced surgeon, the clearest writer and teacher.”

Since 2000, the canvas has been on loan from the university to the PMA.

While recent research has shed light on his pattern of sexual harassment, including allegations that he sexually molested his niece, Eakins continues to be appreciated as an individualist and one of America’s greatest painters. He maintained: “My life is all in my work.”

“A Nation of Artists” runs through July 5, 2027, at the Philadelphia Museum of Art (2600 Benjamin Franklin Parkway, Philadelphia, 215-763-8100 or philamuseum.org) and through Sept. 5, 2027, at the Pennsylvania Academy of the Fine Arts (118-128 N. Broad St., Philadelphia, 215-972-7600 or pafa.org). Note: Exhibit admission is separate at each venue, though discounts are available to view both.