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‘The sick child’: a portrait of tragedy and grief
  1. John Launer
  1. Associate Editor, Postgraduate Medical Journal, London, UK
  1. Correspondence to Dr John Launer, Associate Editor, Postgraduate Medical Journal, London, UK; johnlauner{at}

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The Norwegian artist Edvard Munch (pronounced as ‘Moonk’) is best known for ‘The Scream’, a terrifying representation of a screaming figure standing on a bridge, against a swirling orange sky (figure 1). Munch painted it many times, as well as making prints and etchings of it. The image has been described as the most iconic figure in western art after Leonardo’s Mona Lisa, and it has been used and abused in countless posters, cartoons, animations and souvenirs. Its fame somewhat overshadows Munch’s other works, which is a pity. He produced over 1800 paintings. as well as thousands of drawings, prints and photos, and a number of sculptures and murals. He was also one of the most significant artists of the twentieth century, with a style that is instantly recognisable. Art critics apply labels to him like expressionism and symbolism, but what comes over most powerfully to the unschooled observer is his ability to convey human emotions that most other artists have shied away from, including anxiety and despair. His pictures are gripping not because they are pretty (few of them are) but because they invite us to contemplate aspects of life we might be tempted to minimise or deny.

Munch considered one of his most important works to be ‘The sick child’ (figure 2). He produced many versions of this too. One of them is in the Tate Gallery in London, but the version illustrated here is from the Munch Museum in Oslo. It shows two figures: a girl lying on a bed, and a woman standing by her with her head turned downwards. The girl is looking in the direction of the woman, and towards a fluttering curtain and the light outside. The woman appears to be clasping the girl’s left hand, while the girl’s other hand lies inert on the bed. Typically for Munch, there are bold colours: the girl’s red hair, the woman’s blue dress, the green bedclothes, the black curtain, the white pillow. Just as typically for him, much of the scene is sketched out sparingly. On each side of the bed there is a piece of furniture – one with a bottle standing on it, the other with a half-full glass – but they are indistinct. Our focus is drawn not towards solid, realistic objects, but to the feelings evoked by the interaction between the two people, and by the brush strokes, furrows and thick layers of pigment from which the image is composed,. The original version was the very first picture where Munch established his characteristic style. In his own words: later in life, ‘Most of what I have done since was born in this painting.’1

A common exercise in teaching art – including in medical humanities – is to ask people to examine a painting before learning anything more. So before reading on, you may want to pause to look at the picture for a couple of minutes. What response does the painting evoke? Who might these two people be? What is their relationship to each other and the artist? What do you imagine is the girl’s medical condition? When you do read on, you may be surprised by how much you surmised from the picture alone – as well as discovering some unexpected facts about it.

Life story

Munch’s life story has a significant bearing on ‘The sick child’. His father Christian was a military doctor who had married a woman 20 years younger named Laura. When Edvard was only five, his mother died from tuberculosis, leaving his father to bring the Edvard and their four other children up with the help of Laura’s sister Karen, herself an amateur artist. Edvard’s own health was persistently poor. His father became obsessively religious and the family sank into poverty. One of Edvard’s younger sisters became mentally ill and was later to spend most of her life in an institution. When Edvard was 12, his elder sister Sophie also tragically died of tuberculosis. Edvard later wrote, ‘The angels of fear, sorrow and death stood by my side since the day I was born.’2

After a spell studying to be an engineer, Munch attended art school and fell in with a circle of bohemian painters. Travel brought him into contact with major artists and writers including Gauguin and Strindberg. Over time, critics and the public moved from seeing his art as morbid and eccentric to admiring his individualism, and his capacity to express his inner life visually. By middle age he was famous and wealthy, although he struggled with alcoholism, along with persisting melancholy. He never married, and his relationships with women were mostly troubled. He spent the latter part of his life alone on his estate in southern Norway. His final years coincided with the German occupation of his country; the Nazis had already condemned his work as ‘degenerate’, along with that of Picasso, Matisse and other great artists of his time. He died at the age of 80 in 1944, a year before Norway was liberated. He bequeathed nearly all of his works to the city of Oslo. Munch had kept most of them in his own house, regarding them as his ‘children.’

Traumatic memory

Munch painted the first version of ‘The sick child’ when he was 21, and the last one more than forty years later (figure 2 shows the final version.) Commentators have reflected that Munch’s repeated return to the image may represent his attempt to exorcise the traumatic memory of Sophie’s death. However, the girl here does not particularly resemble Sophie as depicted in photos and Munch’s other paintings, and he used a live model for the painting, so it is both personal and archetypal. Images of sick or dying girls were popular at the time, and Munch may have influenced by some of them: the similarity to the famous picture of Ophelia by John Everatt Millais is striking.3 At the same time, he seems to be offering a critique of the genre by painting something far more authentic. He described how he had gained the first impression for the picture during a hospital visit:

When I saw the sick child for the first time – the pale head with the vibrant red hair against the white pillow – it made an impression that disappeared as I worked on it… I painted the picture numerous times in the course of a year…and endeavoured again and again to attain the first impression – the translucent, pale complexion against the canvas – the quivering mouth – the quivering hands…4

The identity of the adult woman is also more complex than one might assume. Articles and documentaries about Munch sometimes refer to her as their mother, but she had died ten years before Sophie. Instead, it may well be that the woman is their aunt Karen. Although the woman appears to be hiding her face because of grief, her mysterious identity might also signify that the daughter and mother are now being symbolically reunited in death. The abiding impression of many viewers is that the sick girl is more composed than the adult. Some people have noted how the woman seems sunk into her own distress, while the girl is able to look into the daylight, possibly displaying acceptance of her own forthcoming death. As critics have observed, the picture seems in many ways unfinished: a permanent work in progress, struggling towards its own realisation rather than finalising it.

Stillness and beauty

Finally, another image that Munch often painted seems to bridge ‘The scream’ and ‘The sick child’ and can deepen our understanding of both. It shows a distraught child by her mother’s death bed (figure 3) and is almost intolerably painful to look at. It also makes us aware that ‘The sick child’ offers complete reversal of this image – with a scene of stillness and beauty instead, and showing an older child who is able to face her own death in an entirely different spirit. By painting the later scene over and over again for forty years, Munch seems to be demonstrating that he never gave up the search for lightness and transcendence, to counteract the tragedy and grief he had known. While seeing ‘The scream’ or ‘The dead mother’ can evoke a response of shock and horror, ‘The sick child’ has the capacity, commoner in great music and literature but rare in art, to move us to tears.

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.