Art of Medicine
May 2020

Salvation in a Time of Plague

Ginia Sweeney, MA
AMA J Ethics. 2020;22(5):E441-445. doi: 10.1001/amajethics.2020.441.


Health workers offer their skills and care to COVID-19 pandemic patients, just as St Roch offered healing to those stricken by bubonic plague during the Renaissance. This article interprets 3 works of art in light of Roch’s story of illness and recovery and applies key insights of ethical, artistic, and clinical relevance to the COVID-19 pandemic.

Pandemic Pilgrim

Outbreaks of bubonic plague devastated Venice, Italy, throughout the Renaissance. Beginning in the 15th century, a devotional cult sprang up around the figure of St Roch, locally known as San Rocco, who offered solace to those unsettled by the immense amount of death that surrounded them. One early biography documents the reliable success of Roch’s deeds: “Those suffering from the plague, fleeing to the protection of Roch, will escape that most violent contagion.”1 Writers, theologians, and public health officials assumed plague had supernatural origins, acting as a punishment from God against a sinful population.2 In the absence of effective treatment or disease prevention strategies, Venetians turned to these specialized plague saints, hoping desperately that they would intervene on the city’s behalf. As successive epidemics ravaged the city, Venice became a center of the cult of St Roch.

St Roch’s life was first recorded visually, as a figure in several mid-15th century altarpieces, and later in writing, in 2 hagiographic novels published in the 15th century.1 Briefly, the novels relate his life: born to noble French parents in the mid-1300s, around the time of the Black Death, Roch embarked on a pilgrimage to Rome as a young man. Setting aside his privileged origins, donning a hooded robe and carrying a sack and a staff, Roch traveled on foot and stopped short of his destination. He arrived instead in the central Italian town of Acquapendente, which was overcome by pestilence. Roch rushed to the hospital, seeking entry, to the incredulity of the hospital director. Once inside, Roch blessed plague patients, releasing them from the torments of illness.

Psychologically, plague and COVID-19 have caused uncertainty and dread, particularly among those stricken and their loved ones. 

Roch repeated these acts of miraculous healing, spending ensuing years traveling to cities ravaged by plague, entering “houses of the poor and hospitals” to free the afflicted from disease.1 Perhaps inevitably, Roch became infected himself and immediately took refuge in a forest to avoid becoming a vector of further contagion in the city. Although he expected to perish, a fresh-water spring appeared next to him, and a dog brought him bread each day, sustaining him until he recovered.

Representations of Roch

Roch cuts a distinctive figure. Clad in pilgrim’s garb, he was often depicted drawing attention to a plague bubo, a painful swelling caused by the disease, on his thigh. (The bubo would have actually appeared in an affected person’s groin, but artists generally depicted it on a thigh.) This symptom’s representation forges empathetic connection with viewers, reminding them that Roch suffered the disease from which he sought to release others. These images proliferated in Italy during the mid-1400s. For example, in a polyptych by Antonio Vivarini, dated to about 1464 (see Figure 1), Roch appears in the lower right panel, accompanied by the faithful dog who helped nourish him in the forest.3

Figure 1. Polittico coi ss Antonio Abate, Sebastiano, Cristoforo, Venanzio e Rocco, by Antonio Vivarini (Italian, 1440-1480)


Vatican City: Pinacoteca Vaticana. Photo by Sailko. Licensed under Creative Commons Attribution ShareAlike 3.0 Unported.


This representation of Roch continues in an engraving (see Figure 2) dating to 1530 by an anonymous Italian artist, known as the Master of the Die, and is in the collection of the Art Institute of Chicago. Roch is shown bearded, in humble pilgrim’s robes and sandals, with his thigh pressed forward, exposing a darkened patch that likely indicates a bubo. At his foot, the friendly dog carries bread.

Figure 2. St Roch, by Master of the Die (Italian, active 1530-1560) after Raffaello Sanzio, called Raphael (Italian, 1483-1520). The Art Institute of Chicago®. This information, which is available on the object page for each work, is also made available under Creative Commons Zero (CC0).


The Art Institute of Chicago, gift of Bernard F. Rogers, Sr.


In response to another outbreak of plague in Venice in 1478, the Scuola Grande di San Rocco, a confraternity through which non-noble citizens could involve themselves in city governance, was established.4 Members committed themselves to following the charitable example set by San Rocco to serve the poor and sick people throughout the city5 and help eradicate the plague. The following century, the Scuola commissioned a narrative cycle of paintings by Jacopo Tintoretto depicting the life of St Roch, which remain in their original location in the Chiesa di San Rocco (Church of St Roch). In St Roch Ministering to Plague Victims (see Figure 3), Tintoretto represented the saint in contemporary Venice, aboard a lazaretto, a ship on which plague sufferers were quarantined. The artist vividly conveyed the agony caused by the disease through the hordes of sufferers who wince and clutch at their plague-stricken bodies.

Figure 3. St Roch Ministering to Plague Victims, by Jacopo Tintoretto (Italian, 1518-1594)


Venice, Italy: Chiesa di San Rocco.


Roch, at the center of the painting, with his back to the viewer and his face set off by a glowing halo, lays his hands on the bare chest of a sick man. The highly emotional scene inspires hope, implying that Roch could bring his miraculous healing to Venice as he had done, according to legend, in other Italian cities.

Pilgrims Present

Episodes of bubonic plague during the Renaissance resemble the COVID-19 crisis. In both cases, the diseases had enormous economic consequences, leaving many fortunate enough to remain healthy stripped of employment. Large gatherings of in-person worshipers were then, as now, canceled, a move that was protested by some clergy.5 Psychologically, plague and COVID-19 have caused uncertainty and dread, particularly among those stricken and their loved ones.

St Roch offered a balm against this existential anxiety; praying to his image was a tangible action taken by many in the face of horror and can still be done by the faithful today. St Roch’s story, too, visually and narratively expresses health care workers’ courage in risking their own safety, isolating themselves from family to tend to COVID-19 patients. Like many clinicians, St Roch sacrificed his own well-being for the health of others, offering hope when it’s in short supply.

As Megan O’Grady recently noted in the New York Times,6 we don’t yet know which works of art will represent our trials during the pandemic of 2020. But just as artworks, including those of St Roch, play key roles in our memorialization of the bubonic plague, its dead, and its saints, so will art likely shape humanity’s understandings of COVID-19.


  1. Vaslef I. The Role of St Roch as a Plague Saint: A Medieval Hagiographic Tradition [dissertation]. Washington, DC: Catholic University of America; 1984.

  2. Marshall LJ. Waiting on the Will of the Lord: The Imagery of the Plague [dissertation]. Philadelphia, PA: University of Pennsylvania; 1989.

  3. Pallucchini R. I Vivarini (Antonio, Bartolomeo, Alvise). Venice, Italy: Neri Pozza; 1962.

  4. Wisch B, Ahl DC. Introduction. In: Wisch B, Ahl, DC, eds. Confraternities and the Visual Arts in Renaissance Italy: Ritual Spectacle, Image. Cambridge, UK: Cambridge University Press; 2000:1-19.

  5. Cipolla CM. Public Health and the Medical Profession in the Renaissance. Cambridge, UK: Cambridge University Press; 1976.

  6. O’Grady M. What can we learn from the art of pandemics past? New York Times Style Magazine. April 8, 2020. Accessed April 15, 2020.

Editor's Note

Visit the Art Institute of Chicago website or contact Sam Anderson-Ramos at [email protected] to learn more about the museum’s medicine and art programming. Browse the AMA Journal of Ethics Art Gallery for more Art of Medicine content and for more about the journal’s partnership with the Art Institute of Chicago.


AMA J Ethics. 2020;22(5):E441-445.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.