One Work: Marianela de la Hoz

The Doctor, 2018, egg tempera on board, 10 x 8 in.

[Image description: A group of figures in a medical office. In the foreground stands a doctor in a white coat, facing the viewer, while in the middle ground sits a mannequin with red stitches on its body. In the background, a winged figure in a white robe gives a large pill to a patient.]

The first time I saw Marianela de la Hoz’s work, I was transported back to my childhood. This might sound strange—concerning, even—since her intricate paintings feature all manner of calamities, offering her audience a sweeping view of contemporary suffering. They triggered a nostalgia in me, not because I had been through the situations depicted, but because, while I was growing up, my mother collected Catholic art. We weren’t Catholic, but crucifixes and paintings hung on the walls of our family home all the same, and a waist-high statue of St. Francis terrified our small dog. These objects wielded a strange power over me as a child, their vivid imagery offering a corollary to the pain that I was beginning to understand was part of being a human in the world, as well as the hope for transformation—for healing—I now realize we must find within ourselves, in order to keep going.

In my initial encounter with de la Hoz’s engrossing practice, the works reminded me of ex-votos, the small devotional paintings that proliferated in Mexico in the 18th and 19th centuries and are still created today. These narrative images function as a deeply personal petition for divine intervention or as a sign of gratitude. They depict individual misfortune and include the figure of the saint or angel who might help the devotee.

One of the most common subjects in ex-votos is illness. Hemorrhages, smallpox, breast cancer, tuberculosis, COVID-19, and a plethora of other ailments—if the state of the human body has gone awry in any way, it has probably appeared in an ex-voto. More recent paintings in the genre feature modern medical equipment, bringing the practice into the contemporary world. Ex-votos are a tool for the faithful—to ask for healing or thank God for recovery—but also, collectively, serve as a kind of historical record of illness.

I am not religious, but I wish I could put faith in doctors. I wish they were all-knowing, all-seeing, omnipotent beings. Yet, as a person with multiple uncommon chronic illnesses, I have often felt betrayed. By condescending doctors dismissing my pain as all in my head; unwilling to listen to my own knowledge about my body; flippantly recommending dangerous medications; or insisting on elaborate surgeries to fix something easily treated by a safe, once-a-day pill. I don’t want to vilify doctors as a whole. I’ve had some good ones, some have even saved my life. And in the capitalist nightmare that is the United States in 2024, broad access to healthcare is a privilege—I am fortunate to have been able to see many doctors, to chase diagnoses and treatment. But there is a particular kind of pain that arises when a doctor denies my embodied experience, rejecting their duty of care for what is easy or profitable. That sense of invisibility–of helplessness, even at times hopelessness–hits at a spiritual level, for it feels as if my personhood is, again and again, being denied. 

I experience a flood of that pain when I look at Marianela de la Hoz’s 2018 work, The Doctor. Its formal qualities echo those of the votive tradition, its subject matter bringing the genre into the present moment. The scene depicts a doctor’s office with beige walls and a striped, medical-green carpet. In the foreground, a doctor stands behind a desk, hands planted authoritatively on its edge, staring directly at the viewer, face covered by a mask. The desk’s top is littered with an accumulation of pill bottles and prescription pads, as well as a syringe full of blood. These instruments are the doctor’s domain. His position in the foreground, his stance, and his arsenal of medical paraphernalia read as powerful, immovable.

In the middle ground, to the right, a mannequin sits on a rolling stool. Stark red wounds, bound by stitches, lattice the figure’s arms, legs, torso, and—most disturbingly—face. It’s something out of a horror movie. Next to the figure hangs a metal cage containing a skeleton, which holds a scythe.  

In the background, to the left, a patient sits on an exam table while a winged figure in a long white gown force feeds a large pill down their throat. This winged figure, de la Hoz told me, is Archangel Raphael, the angel of healing. Snaking around the bottom of the angel’s robes are lampreys, the parasitic fish whose rings of sharp teeth latch onto its host so the creature can feed on its blood. To the right of the angel, a snake curls on the top of a wooden staff, recalling the Rod of Asclepius, an ancient Greek symbol associated with medicine. 

The original Hippocratic Oath from fifth-century BC Greece begins, “I swear by Apollo the Healer and Asclepius,” and many subsequent versions go on to utter some iteration of the line, “First do no harm.” Did the doctor in de la Hoz’s scene take this oath?

Mulling over de la Hoz’s painting, I wonder what version of the Hippocratic Oath doctors use today. When I look it up, I am shocked—by its humility, its generosity, its heart. The text most medical schools use presently was composed in 1964 and reads: 

“I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”

It sounds like a dream. A wish. Perhaps a prayer. A prayer for a type of care so often impossible under the current medical industrial complex, in which profit motives breed both overtreatment and therapeutic nihilism. De la Hoz herself has experienced the harrowing nature of this system; we both know what it is to need healing and, when seeking it, find disregard. We also share a familiarity with ex-votos, since de la Hoz grew up Catholic in Mexico. If ex-votos have constituted a historical record of illness, her painting marks the contemporary moment, in which many patients must fight to maintain their personhood in an inhumane system. With my complicated health issues, I am exhausted by this effort, but I find my agnostic self offering a prayer to whatever is out there. That I can continue to resist complacency, despondency. That I can keep the faith that some kind of healing is possible.

—Elizabeth Rooklidge, Founder and Editor, HereIn