Art of Medicine
Dec 2019


Antonio Yaghy, MD
AMA J Ethics. 2019;21(12):E1103-1104. doi: 10.1001/amajethics.2019.1103.


This image of a silhouetted figure looking out over a body of water at sunset aims to promote reflection about patients’ feelings of sadness, despair, helplessness, and uncertainty upon being diagnosed.


Figure. Contemplating Illness



Digital photo-painting.


This image seeks to depict emotions a patient might feel when contemplating illness or diagnosis of disease. Illness has been defined as a “subjectively interpreted undesirable state of health,”1 whereas disease is understood as an objective conclusion about a patient’s health based on scientific reasoning.2 One view of a patient-clinician encounter is that it should aim to dissolve distinctions between the subjectivity of illness and the objectivity of disease. To achieve this goal, a physician must diagnose and treat patients with compassion and motivate patients’ understanding of their disease. Patients who understand their disease in turn will be more likely to have reasonable expectations regarding treatment and prognosis.

The image invites an observer’s visual exploration of sadness, despair, helplessness, and uncertainty by the use of dark tones, which dominate the negative space, and by a silhouetted figure in the foreground that looks out over a body of orange-colored water suggestive of a time close to sunset.


  1. Twaddle A. Disease, illness and sickness revisited. In: Twaddle A, Nordenfelt L, eds. Disease, Illness and Sickness: Three Central Concepts in the Theory of Health. Linköping, Sweden: Department of Health and Society, Linköping University; 1994.

  2. Seidlein AH, Salloch S. Illness and disease: an empirical-ethical viewpoint. BMC Med Ethics. 2019;20(1):5.


AMA J Ethics. 2019;21(12):E1103-1104.



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.