A tale of two ears
Authors: B. Cohen
Journal: Journal of the Royal Society of Medicine (2003)

The left ears, the subject of this communication, are those of Rembrandt Harmensz van Rijn—to give him his full name—and Vincent Van Gogh. Some of the features of Van Gogh's ear injury are well known, but in Rembrandt's case my explanation of the appearances of that ear are new to the canon and were sent to the Rijksmuseum in Amsterdam in 1999.

There was an exhibition of Rembrandt's self portraits entitled ‘Rembrandt by Himself’ in the National Gallery in the autumn of 1999 with an accompanying heavily illustrated book-cum-catalogue which included a learned essay on the portraits. Rembrandt painted himself before the mirror on at least 40 occasions, etched himself 31 times and made also some drawn self-portraits.

On entering the first room I was immediately struck by the appearance of Rembrandt's left ear in the portrait painted c. 1628 at the age of 22 (Figure 1). The left lobule was occupied by a round swelling with a small bunch of what were apparently granulations at the upper edge. This swelling was also present in some later portraits, but by about 1642 it had become a thickening. The 1628 portrait was particularly clear as the artist had highlighted the left ear, face and neck. However, in some later portraits the artist had the left ear in the shade or obscured by his locks. The abnormality is not evident in the sketch illustrations or etchings.



Figure 1

Rembrandt, self-portrait of 1628. Rijksmuseum, Amsterdam. As with all self-portraits, this is a mirror image, with the left ear appearing to be the right



My immediate surmise was confirmed by noticing that in a work of 1629, where he wore a plumed beret, there was an ear-ring attached very near the tip of the lobule—i.e. below the swelling. This also appears in many later paintings. The thickening of the pinna is still evident in the final one of 1669. Probably the lobule was so indurated that it could not be pierced again except below the infected area. He must have been a very determined young man to risk further damage to the ear. This portrait also reveals that, even at 22 years of age, the artist was intensely honest with himself in portraying such an ugly appearance. Was it bravado or was it an example of his sense of humour (which comes through in much of his work)? He could, instead, have painted the right side of his face. The exhibition book states that the enlarged ear lobe is a striking feature of virtually all Rembrandt's painted self-portraits, but offers no reason for it.

It is not uncommon to see pinnae which have become infected as a result of ear piercing. An implantation dermoid may also occur as a nodule deep to the point of piercing. This swelling in Rembrandt's pinna could have been a simple abscess discharging at the top edge, leaving him with a thickened lobule, or a dermoid cyst that had become enlarged by infection and discharged similarly. I am inclined to the latter explanation. The curious feature of all this is that, in almost 300 years, mine is the first attempt at explaining such an obvious deformity.

The story of Van Gogh's left ear is quite otherwise. Accounts vary considerably of this self-mutilation and some are obviously overdramatized. Gauguin, a close friend of Van Gogh, gave an account some 15 years after the event. The incident occurred at Arles where Van Gogh lived in his Yellow House. He was at the time at odds with Gauguin. They had quarrelled frequently and Van Gogh was subject to periods of depression and wild behaviour. On 23 December 1888 he met Gauguin nearby in the street and brandished a razor at him. Probably Gauguin was due to stay with Van Gogh, but Gauguin left him and booked himself into an hotel. Later at night Van Gogh, in front of a mirror, slashed at his left ear with the razor, took off a portion and put it into an envelope. He then rushed down to the local brothel (maison de tolerance) and presented the envelope to a young prostitute there called Rachel, with advice to ‘keep this object carefully’. She promptly fainted. Apparently Van Gogh was jealous that she had preferred Gauguin to him.

Van Gogh was taken home by his friend Roulin. The police were called next day by the madame. He was slouched in bed, with some blood on the bedclothes. (However, one version says that Gauguin visited him on the day after the incident, found him in bed and called the police.) The patient was in hospital for fourteen days, and seemingly the lesion healed quickly. Some recent writers have described Van Gogh as almost unconscious, declaring that he would have died had he not been taken to hospital. However, it is very improbable that blood loss was severe. The lobule has a modest blood supply.

Van Gogh at the time was going through one of his frequent periods of depression. He had established an intimate relationship with Gauguin and there was a scheme to set up a school of painting; it came to nought. The phenomenon of self-mutilation is well understood nowadays. One authority suggested lately that the specimen of ear represents a phallic symbol; I hesitate to comment. Gauguin left Arles a few days later.

The self-portrait painted in January 1889, with the artist wearing a fur cap and his left ear roughly bandaged around his chin, is well known (Figure 2). The bandage was presumably to hide the ear wound. There are two versions of this painting, one in the Courtauld Institute, London (60 × 49 cm) and the other in a private collection in Chicago (51 × 45 cm) but in the latter he has a pipe from the right side of the mouth. Otherwise the portraits are similar. There is no self-portrait showing the left ear uncovered. However, a sketch by his friend Dr Gachet of the artist on his death-bed, signed P van Rijssel (a pseudonym), does show the left ear. The drawing is poor but most of the pinna is intact (Figure 3). The likely injury was to a part of the lobule, with or without slight injury to the helix.



Figure 2

Van Gogh, self-portrait with bandaged ear, 1889. (Courtauld Institute Gallery)





Figure 3

P van Rijssel, Van Gogh on his deathbed. (Reproduced by permission of the Van Gogh Museum, Amsterdam)



Van Gogh died on 27 July 1890 two days after shooting himself in the lower chest or epigastrium.