When it comes to pain, we all expect relief. Total relief. But it was not so long ago that the treatment of commonplace ailments and disease was not so pain free. Take a look at fine art and advertisements over the last several centuries, and the human preoccupation with pain becomes, well, painfully clear.

And that is just what Fred Spielman, M.D., anesthesiologist and professor of anesthesiology at UNC Hospitals, has done. He has studied the history of his profession using the world’s art museums. Spielman has become an established researcher, writer, and lecturer on the progress of pain control in medicine and its depiction in art.

“Art is a place to be creative and to find your other self,” he says. “That’s why I have come to this place. That coupled with an interest in the history of medicine—it was a natural pairing of the two.”

When Spielman stopped to consider where the world was just 100 years ago in the use of anesthesiology, he realized that a rich and vibrant history of pain control and its documentation was virtually undiscovered.

“Art gives us a unique perspective on the history of anesthesiology,” Spielman says. “Art tells us what the people and culture thought about medicine at the time the art was created.” Throughout history, art was a way to document medical procedures, and during periods when few were literate, such as the Dark Ages, art was a direct means of education and communication.

Visual images from any era are crucial to understanding how society—the public as well as the medical profession—views the connection of pain control and medicine, Spielman says. An artist’s rendering may depict early anesthetics such as herbs or alcohol, or show the use of opiates or modern-day pharmacology. Each image conveys how the artist or society viewed the use and merits of the anesthetic.

But while such works are plentiful, they are rarely studied. As a trail-blazing scho-lar in the art of pain and anesthetics, Spielman had to find the art himself. Most of the images he has studied were scattered among the world’s museums, private homes, and historical archives. He also had to find funding. In 1993, his research got a jump-start from Wood-Library Fellowships, which are sponsored by the American Society of Anesthesiologists. After successfully identifying a number of media to study, Spielman was granted fellowships by the Burroughs Wellcome Fund to continue his research in London.

The grants allowed him to travel and correspond with historians, curators, and patients around the world—the first step to discovery, Spielman says.

“I have art that has been painted by surgeons, wonderful images in the hospital,” Spielman says.

Art created by doctors and patients is especially significant to Spielman. He believes art used as therapy can often speak volumes for patients who can’t adequately explain their pain.

Georgia O’Keefe once used a headache as inspiration. O’Keefe wrote, “Drawing No. 9 is the drawing of a headache. It was a very bad headache. Well, I had the headache, why not do something with it?”

Spielman has met many patients who paint or draw as a form of therapy. They sometimes create images of their anesthetic-induced experiences.

The story of an English woman particularly grabbed Spielman’s attention. She entered an English hospital for an operation in 1960. Unfortunately, she roused during the procedure but couldn’t communicate with the physicians. The horror she felt while conscious was heightened when she could not convince her doctor or family that she had experienced the operation firsthand. To help deal with her experience, and to prove her story, she painted a picture of the operating room during the procedure.

Art can help patients, Spielman says, if it reminds the doctor to consider the patient as a person. Simply paying attention to a patient’s feelings and talents can help create a stronger doctor-patient relationship. “We’re very good with technology and diagnoses and treatment, and we can cure infections well,” Spielman says, “but perhaps we’re not spending enough time with our patients as we did a generation ago.”

John Stuart Curry’s Front Line Surgery, c. 1943, shows the traditional role of an anesthesiologist during surgery. The anesthesiologist stands at the head of the patient—a guardian and protector.

A typical image of pain control in the 1990s, by contrast, would “unfortunately be a picture that depicts technology and the impersonalization that we see in medicine,” Spielman says. For instance, a 1990s rendering of the operating room shows the anesthesiologist separated from the patient by a wall of dials, buttons, and tubes. The modern operating room has been transformed by technology, slowly detaching the patient from the doctor, Spielman says.

His research, he says, has made him think long and hard about his place in his profession.

“A common complaint about physicians is that they’re not emotional enough, they’re not in touch with their emotions, they’re not emotional with their patients. I’d like to think that my interest in art has helped me get in touch with the creative side of me and has helped me become more emotional and compassionate with my patients.”

Reaching people through his research has motivated Spielman to produce more than a half-dozen articles for the American Journal of Anesthesiology, in addition to a growing list of lectures at places such as Duke University Museum, the National Institutes of Health, and the Chicago Society for the History of Medicine. In each case, he has had the satisfaction of sharing his discoveries at the same time he’s indulging his passion for art.

“So much we see in hospitals assaults our visual senses,” Spielman says. “A bloody patient. A patient in pain. It’s a nice antidote to some of the cruel and ugly things that we see every day in hospitals—to see something pleasurable, see something beautiful.”