Mexican artist, Frida Kahlo, is arguably one of the most well-known painters of the 20th century. Her intimate and personal self-portraits are evocative, generating a deep, almost visceral response. Through her paintings, Frida opens a door and invites the viewer to witness something that is both frightening and profound: her lifelong experience with chronic pain. With more than 40% of American adults experiencing chronic pain, her work is particularly relevant in our contemporary society. The consequences of chronic pain are staggering—individuals with this disease often struggle with depression, disability, social isolation, and poverty. However in Frida, one perceives a courage, a Mexicanisimo, in the face of a disease that has affected the quality of life of so many. While many art historians have analyzed the work of Frida Kahlo, less considered are the neurophysiologic mechanisms underlying her pain and disability. Through her story, her narrative, we learn, perhaps implicitly, how to respond to the adversity of chronic disease.
Frida was born during the Mexican Revolution, a time of political tumult and rebirth of Mexican identity which allowed her to develop into a liberated and independent young woman. Several events in her life, however, would predispose her to chronic pain, a disease that would ultimately claim her life. Early in her life, Frida contracted polio, a devastating infectious disease that attacks the anterior horn cells of the spinal cord. The six-year-old was left with paralysis and atrophy of the muscles of her right lower limb, and ultimately a limb length discrepancy. A sequelae to this terrible disease is post-polio syndrome, characterized by extreme fatigue, new onset of muscle weakness, and severe pain. While Frida experienced many of these symptoms in later life, an accident in her teenage years would overshadow concerns over post-polio syndrome.
At age 17, Frida sustained significant trauma during a streetcar accident, including multiple fractures of clavicle, ribs, spine, elbow, pelvis, leg, and foot. Her right foot was crushed and both ankle and shoulder were dislocated. An iron handrail from the streetcar pierced her left hip and exited through her pelvic floor. Infection ensued and she was not expected to survive. Over the long months of convalescence, Frida faced significant pain and social isolation. She did survive however, and with encouragement from her father she turned to painting. As she made her way back into society, Frida reached out to the famous and charismatic painter, Diego Rivera for encouragement. They would eventually marry.
Frida’s relationship with Diego was alternately passionate and emotionally devastating. She vacillated in her desire for a child and her fear that a child would affect her relationship with Diego. Early in their marriage, Frida experienced a miscarriage that plunged her into despair. At the same time, Frida began to experience a cascade of serious physical ailments, including low back pain, neuropathic leg pain, and vascular insufficiency in her right lower limb. She would be advised to undergo numerous surgeries as treatment, with some disastrously unsuccessful. Many of these life events would be portrayed in her paintings. Frida would become addicted to alcohol and both prescription and non-prescription medications. She died young of a reported pulmonary embolism, however some sources have suggested that it may have been suicide.
This compilation of experiences is characteristic of chronic pain. Emotional, psychological, and physical inputs can facilitate pain mechanisms, promoting worsening symptoms and widespread pain. If Frida lived in our contemporary society, would her health care be better? The answer to this is not clear. Health care providers and scientists are beginning to recognize the underlying mechanisms and clinical characteristics of this disease, although proper management is far from being fully understood. What is compelling about the life of Frida Kahlo is that she rejected the role of ‘afflicted’ and chose to engage fully in society with dignity. Without a doubt, she suffered from tremendous pain throughout her adulthood, yet it is how she chose to live life, not her chronic pain, for which she is remembered. Frida used her painting as a way to separate from the pain and emotional stressors of her life and create representations of her experiences of pain and trauma. This visual narrative provides insight into her life experience and may provide healthcare providers and patients alike a better understanding of chronic pain.
Featured Image Credit: Frida Kahlo House, Mexico City by Rod Waddington. CC BY-SA 2.0 via Wikimedia Commons.