Art in Science: Velázquez and Dwarfism-The Art of Observation.

The terms “dwarf” and “dwarfism” (generally applied to individuals with achondroplasia) have a relatively recent appearance in the medical literature [3, 9]. The terms were first used in a clinical manner in the late 19th [13] and early 20th century [12], but did not become established for this purpose until associated with the detailed descriptions of the genetically based condition of achondroplasia in the 1950s [8]. Regardless of when the first medical reference to dwarfism appeared, that date is far more recent than the descriptions depicted with incredible accuracy by Spanish painter Diego Rodrı́guez de Silva y Velázquez (1599-1660), under the patronage of King Philip IV [7]. Born in Seville, in southwest Spain, Velázquez was a descendent of tradesfolk from Portugal who probably were Jewish conversos (products of the Inquisition) [14, 15]. He pursued his passion for art with formal training prior to the age of 12. Before leaving for Madrid in 1622, Velázquez was already established as an outstanding artist in Seville. With the introductions and opportunities afforded by his regional fame and his demonstrated talents (and the recent death of King Philip IV’s previously favorite painter, Rodrigo de Villandrando), he quickly won favor at the royal palace. Approaching the end of his highly acclaimed career, and despite his humble lineage, Velázquez was knighted in 1658 [4, 6]. Velázquez’s portraits, with their outstanding detail and perspective that reflected both technical realism and emotional transparency, remained his primary focus toward the end of his formidable career. One of his most acclaimed portraits, Las Meninas (The Ladies-in-Waiting; [Fig. 1]), includes images of dwarfs, and serves as an incredible example of his observational skills [7] Velázquez has likely contrived the scene depicted in Las Meninas, and done so to make several points [6, 10]. Most obvious is the insertion of the artist himself at the far left, as he is the largest figure in the painting. Depicted with brush, palette, and mahlstick in hand, he is in command of the content of the canvas by virtue of skill and observation. Indeed, Velázquez is making a statement about the control the artist has in the creative process of painting. The scene also provides commentary on the nature of the royal court, but his focus on the young infanta (Princess Margaret Theresa), absent the physical presence of King Philip IV and QueenMariana (although their reflections are seen in the mirror on the back wall), allows an informality and relaxation unavailable, by convention, in formal depictions of adult nobility [5]. The young regent, in the center of the painting is surrounded by attendants, including a chaperone, body guard, the queen’s chamberlain and head of the royal tapestries standing in the doorway, as well as her dog and two dwarfs at the far right of the canvas (Fig. 2). The dwarfs, A note from the Editor-in-Chief: I am pleased to present the next installment of “Art in Science,” team-written by Gary Friedlaender and Linda Friedlaender. Gary is the Wayne O. Southwick Professor, and Chair Emeritus for the Department of Orthopaedics and Rehabilitation at Yale School ofMedicine; Linda Friedlaender is the Senior Curator of Education at the Yale Center for British Art. Together, they will share observations from a fascinating vantage point: The intersection of art and medicine. We welcome reader feedback on all of our columns and articles; please send your comments toeic@clinorthop.org. The authors certify that neither they, nor any members of their immediate families, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. G. E. Friedlaender MD (✉), Yale University School of Medicine, PO Box 208071, New Haven, CT, 06520-8071 USA, Email: gary. friedlaender@yale.edu