Art in Science—Humility: As Portrayed by Pietro Lorenzetti

In the closing days of his own life, Pietro Lorenzetti (c.1280-1348), one of the most noted artists of the 14th century, completed Life and Miracles of Saint Umiltà, a polyptych (a painting divided into sections [10]) chronicling the life of Umiltà (born Rosanna Negusanti, 1226-1310). Umiltà, Italian for humility, founded the Vallombrosan order of nuns in Florence, Italy and later was canonized as Saint Humility [1]. Umiltà Heals a Sick Nun (c. 1341) (Fig. 1), one of 13 individual story panels included in Life and Miracles of Saint Umiltà, describes Umiltà’s journey to canonization in the Catholic church. The oil on wood panel is an excellent example of the art of the period and offers a commentary on the roles of medicine and faith in the care of seriously ill patients during her era.

Fig. 1.

Pietro Lorenzetti, Umiltà Heals a Sick Nun, c.1341, Oil on wood panel, Uffizi, Florence, Italy.

The collected scenes from the Life and Miracles of Saint Umiltà have since been broken up into individual pieces. Most of the pieces reside in the Uffizi Gallery in Florence [8]. Umiltà Heals a Sick Nun and one other piece, however, are displayed elsewhere. Umiltà now hangs in the Gemaldagalerie, part of the Staatliche Museen in Berlin, Germany [11].

The painting captures three contiguous interior scenes within a religious residence, most likely a convent, each space larger as one’s eye moves from left to right. The smallest cut-away on the far left is a dark, mysterious room, the middle ground includes three standing figures, and the largest room, on the right, depicts three nuns, one in bed. A be-haloed Umiltà dominates the scene as the largest figure in the painting, standing at the foot of the bed.

The most remarkable characteristic of this work apart from the narrative itself is the ambitious introduction of perspective. Giotto di Bondone (c.1268-1337) is credited with introducing this technique [3], which had been absent from the preceding 800 years of medieval art. Here, the artist Lorenzetti creates depth in every portion of the building by using strong diagonals and a three-dimensional treatment of walls that preceding artists would have rendered as flat lines. The technique here foreshadows some paintings of the Renaissance. As viewers, we stand in front of the room on the right, where the most significant event occurs. It was the goal of these multipaneled religious scenes to tell stories, describe events, and teach lessons in ways that did not require access to written materials or the ability to read in a population that largely lacked both. Symbolism replaced words. The most important figure in paintings of this genre usually is the largest, and he or she typically is dressed in the most colorful and ornate clothing. This individual’s role is identified by a recognizable costume or insignias, perhaps—as here—one as basic but important as a halo.

The story begins on the left in darkness. Life is unpredictable.

The cross on the roof of the building on the left side of the painting denotes the structure as a sacred place. A bell contributes to the notion of a church-like structure, calling people to worship and tolling the passage of time. The tree ambiguously hovers either over the roof or, more likely, just behind the structure, rising from the sandy beach in front of the water. Painted with an inner lighting, this is the tree of life.

In the center, but of secondary importance, the individual in the forefront holds his or her hands in a gesture of resignation or defeat, amplified by the skewed position of the head. This is the physician. The other two figures stand back and, like the physician, are plainly dressed; one holds a bowl containing red fluid. On careful observation, the physician’s robe appears to have some red stains. These individuals are likely assisting the physician with his recent intervention, and the bowl may display the results of a blood-letting procedure. Medical options were limited. This phlebotomy was of no use, and the team has been relegated to a side room, no longer able to provide the necessary care for the patient. The bell directly above their heads may suggest their time for helpful intervention has run out.

The room on the right is central to the story. The three nuns, one sitting up in bed and two standing in support of her at the head of her bed, all have the same generalized facial characteristics. Indeed, with the exception of the fuller face of the physician, everyone has a similarly expressionless appearance. This stylized approach was common in medieval art. There was no effort to distinguish people based on facial or physical realism, but rather to use costumery or visual symbolism to differentiate individuals by what they did or represented [7]. The outlier in appearance in this room is the figure on the far right. She is taller than anyone else, dressed in plusher, more copiously folded fabric, and wears an adorned head piece topped by the unmistakable halo. She extends her right arm toward the patient in a gesture of benediction. Her gaze suggests a connection to and concern for the sick nun, an act of compassion. Umiltà represents religious faith; here, that means both salvation and the power to heal. Despite her enriched appearance, her dress and modest adornment (except for the halo) is neither regal or ostentatious, conveying the sense of humility from which her name derives.

Pietro Lorenzetti was born in Siena, Italy where he also died in his late 60s. Although his art was prolific and impactful, relatively little is known about his personal life. Even the dates of his birth and death are estimates [5, 9]. He apparently moved around Tuscany—principally in Siena, Assisi, Florence, and Cortona—to complete many commissions that were situated in numerous churches, monasteries, and places of devout religious practice. Lorenzetti was one of the individuals featured by Giorgio Vasari amongst his famous biographies of influential artists, first published in the mid-16^th century [12], because he was a major driver of the evolving Gothic realism movement that defined the final artistic style of the Middle Ages (1347-1500s) [7]. His oeuvre built upon the works of Giotto and Duccio di Bouninsegna. Regrettably, Vasari misidentified Lorenzetti’s last name (which he interpreted to be Laurati), and perhaps for this reason, Pietro Lorenzetti was not recognized as the elder brother of Ambrogio Lorenzetti, who independently achieved high recognition for his art, sometimes in close collaboration with his sibling [5]. Extrapolating from the dates of their deaths, the brothers may have been both victims of the Black Plague, which first appeared in western Europe in 1347 and caused the demise of at least one-third of the continent’s population [4].

Lorenzetti obviously appreciated Umiltà’s pious life, but he could not have known she would be beatified in 1720 by Pope Clement XI [1]. Rosanasa renounced a life of privilege and took on a chaste, humble, and devout commitment, in part a response to (or repentance following) the death of her two young children [8, 11]. When Umiltà was made a saint, the Church required that any candidate for canonization would have performed at least three miracles (a requirement reduced recently to one [2]). Umiltà far exceeded the standard applied in her time; she was credited with self-curing her renal cancer, healing the diseased feet of a monk previously destined for amputation, reviving a dead boy, and causing ice needed to treat fever to appear in a previously dry well [6, 11].

It is interesting that more than 90% of miracles said to have been performed by saints were medical [2]: the saint intervening to heal or reverse a serious illness or physical disorder. Physicians play a strong consultative role in the canonization process, and when the Church explores these claims, it asks physicians to attest that there was no misdiagnosis or other scientific basis for the restoration of health. Indeed, perhaps the physician in Umiltà Heals a Sick Nun, is signaling his concurrence with the miraculous nature of the intervention, which followed the failure of then-modern medicine. Patients sometimes will respond to illnesses in ways we cannot predict or understand. This should keep us humble.