St. John the Baptist in the Wilderness: the art and science of clinical observations


St. John the Baptist in the Wilderness: the art and science of clinical observations 

by Ger T. Rijkers1,2,3*

1Department of Sciences, University College Roosevelt, Middelburg

2Laboratory for Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands

3Co-Editor in chief, Pneumonia.

*Corresponding author: Ger T. Rijkers, Department of Sciences, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, Netherlands. Tel: +310118655500; Fax: +310118655508; Email: This email address is being protected from spambots. You need JavaScript enabled to view it.



At a liberal arts and sciences college such as University College Roosevelt, biomedical professors and researchers are not only surrounded by colleagues from closely related fields such as biology, chemistry and statistics, but also by (art) historians, philosophers, sociologists, and other representatives from the complete academic spectrum. This makes it sometimes more difficult to explain the relevance of your own work, but it always forms a great source of inspiration and discussions which can take an unpredictable course. As an example: how to interpret an image?


In pneumonia, an important step on the path to reach a clinical diagnosis is the correct interpretation of the image of the lung, be it a conventional x-ray or more innovative imaging techniques. What you see is what you get, and therefore, it is crucial to know what you see. In the medical sciences this may sometimes be difficult, but the same holds true for the arts.


In the painting “Saint John the Baptist in the Wilderness” by Jheronimus Bosch (Figure 1, panel a), Saint John himself in his red robe is depicted like a centerfold avant-la-lettre. His right index finger is pointing towards a lamb, an obvious link to his biblical role of baptizing Jesus Christ. Closer observation reveals a plethora of animals and strange creatures in the background landscape. Their role is unclear as it is also unknown whether these details are needed for correct interpretation. When using an alternative imaging technique to the human eye, namely infrared reflectography, a different image shows up. Standing next to Saint John is the figure of a donor, apparently hidden by Bosch in the final version of the painting. During those days, the donor who commissioned the work, and also paid for it, demanded to be included in the scene. When a donor changed his mind, or died before the painting and the deal were completed, the painter faced a problem. The usual solution was to hide the donor, in this case by painting some bushes on top of him. The full and correct interpretation of the image therefore, requires innovative techniques. Interpretation both of medical as well as artistic images can be difficult. In up to 60% of cases of pneumonia, the specific cause remains unknown and unseen. Should we look better or differently? Observation is critical because what you don’t see, you can’t treat.  Take your time and use different angles.


Have you become interested in Jheronimus Bosch’s meaning for the medical sciences? Search for titles of his other paintings on PubMed.



Figure 1: Saint John the Baptist in the Wilderness by Jheronimus Bosch, dated around 1489 (Museum of Lázaro Galdiano, Madrid, Spain). Panel a shows Saint John dressed in his red robe, pointing his right index finger at a lamb. The infrared reflectogram (b) reveals the (unknown) donor.

(Wikimedia Commons: Jheroniumus Bosch, Paintings)



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Tuesday, 20 August 2019