La Cortisone

Tomorrow I sail to Boston in search/Of my hands. . . . Fifteen years ago the attacks began. Disfiguring my hands/As if I were painting with leaden gloves. . . . My only wish: to draw freehand/Following the wind/Flowers that beckon me/And capturing them/In a vase of Anemones.

—Raoul Dufy, April 1950^1(p286)

In December 1949, Freddy Homburger, MD, a skilled watercolorist, saw a photograph of French painter, illustrator, and decorator Raoul Dufy (1877-1953) in Life magazine that showed his hands had been deformed by rheumatoid arthritis. The renowned artist, one of the most popular of the 20th century, was increasingly disabled, could not stand without help, and struggled to paint using only his left hand, having lost the use of his right. Dr Homburger, familiar with recent treatment trials with ACTH (corticotropin) and cortisone for arthritis, wrote to Dufy, explained the risk of participating in clinical research, and offered to hospitalize him on his research unit in Boston should he decide to participate in a clinical treatment trial. Dufy's physician, familiar with the groundbreaking research of Philip Hench, MD, on the treatment of arthritis with cortisone at the Mayo Clinic in Rochester, Minnesota, encouraged him to accept. On April 6, 1950, Dufy responded with gratitude, writing, “You bring me today my recompense in offering your art and your science in the alleviation of the pains of my illness.”^2(p60)

Like Pierre-Auguste Renoir, who suffered from debilitating rheumatoid arthritis until his death in 1919, Dufy had continued to work despite his illness. Dufy wrote of Renoir, “his son bound the bristles [of his brushes] to the hollow of his hand.”^1(p286) Renoir painted with his brush wedged in the first metacarpal space, held between the forefinger and second finger, which allowed him to hit the canvas with small and rapid strokes. Dufy's hands, like Renoir’s, were frozen. In Chantilly outside Paris several days before his departure for Boston, Dufy wrote a prose poem (epigraph) expressing his hopes to be “released from the bonds of arthritis.”^1(p286)

In Boston on April 29, 1950, before beginning his treatment, Dufy dedicated a cramped watercolor to Mrs Homburger, shown as the top image in Figure 3 in Homburger's New England Journal of Medicine article.³ The figure's lower image shows the dramatic improvement in his art after treatment with both ACTH (corticotropin) and cortisone. With medication, exercise, and physical therapy, he regained his manual dexterity. Dufy sketched his progress on doilies on his meal tray.

Dufy's joy in his improvement was so great that his doctors suspected elevated mood due to his medication,⁴ but Bertha, his mistress, insisted that this was his “old self.” She reported too that his sexual libido had returned. Negative emotions may be linked to artistic creativity, but apparently this was not the case for Dufy.

With improvement, Dufy grew restless and left the hospital. He settled in a hotel on the banks of the Charles River to paint. Knowing that his doctor was a painter was reassuring to Dufy; they sketched together outdoors. Dufy spent 14 months in America. When he left Boston, he went to rest in Tucson. He painted gardens, harbors, racecourses, and city scenes. Dr Homburger wrote that his response was “rapid, gratifying, and sustained.”² Dufy completed 200 works of art in the 3 years following his treatment.

Dufy showed his thanks through involvement with benefits for the Arthritis Foundation and making gifts of his paintings. With renewed productivity, he produced 33 items for an exhibit that toured New York and Boston beginning in January 1951. On December 10, 1950, Dr Hench, a rheumatologist from the Mayo Clinic, was corecipient of the Nobel Prize in Physiology or Medicine for “discoveries relating to the hormones of the adrenal cortex, their structure and biological effects,” especially for treatment of rheumatoid arthritis. Aware of Hench's honor, Dufy gave a set of 10 original floral prints to Hench (Figure), inscribing on them “La Cortisone.” One still hangs today in the rheumatology patient waiting area at the Mayo Clinic. Faded with time, it allows better visualization of Dufy's precise line work.

The capstone of Dufy's recovery and career was winning the grand prize at the Vienna Art Biennial in 1952. He followed Renoir's example, telling Homburger that he hoped to live to age 85 years to round out his work. Dufy died at age 76 years of an intestinal hemorrhage, most likely a complication from his 3 years of continuous treatment with salicylates and cortisone. A few days before his death, he said that he had always rejected all that was not beauty and had “never suffered from ugliness.”⁵ He said that he had never left a “single thing in the dream world that asked to be born.”⁵ Satisfied that he had always worked to his maximum ability, he said, “I can die peacefully.”^5(p7) His medical treatment for rheumatoid arthritis made this possible.

Dedicated to Julia Charles, LF, MD, PhD.

Thanks to Dr Charles, who recommended the La Cortisone print; Kay Brune, MD, PhD, Erlangen Nürnberg University, Germany, and Ralf Wettengel, Jena, Germany, who identified the source for the cover image; Eric Matteson, MD, and his staff at the Mayo Clinic, Rochester, Minnesota, who provided the La Cortisone print for the figure; and Mayo Clinic librarian, Ann M. Farrell, and Johns Hopkins University History of Medicine librarian, Christine Ruggere, for their kind assistance.