Pulchritudo ex machina: Beauty from the machine

Art is a way of recognizing oneself.

– Louise Bourgeois

As palliative care patients increasingly access art therapy (Lin et al. 2012; Collette et al. 2021; Ganzon et al. 2020), perhaps we can glean some insight into patients’ meaningful experiences and the successes and failures of palliative medicine. One recent expansion of access to the visual arts is the development of artificial intelligence (AI) art software such as DALL-E and Midjourney, where the user inputs a written prompt and quickly receives visual art pieces. I thought it would be interesting to see what themes the AI associates with palliative care, as doing so might provide insight into the experiences of artists presumably interacting with palliative medicine.

I instructed the AI Midjourney to create digital art with the prompt “palliative care” without specifying any additional parameters or providing information to work. I produced several hundred pieces of new, original artwork using this prompt and looked for common themes.

The first theme I noticed popping up repeatedly was flowers. Some pieces featured individual flowers. They were also shown as bouquets in vases, often at bedsides, and in stunning fields in bloom. In many cases, such as in Figure 1, the flower was a poppy. The poppy flower, with its red-orange petal and black center, typically represents consolation and the eternal sleep of death. It is also a symbol of remembrance – in many countries, for example, Poppy Day is World War I Memorial Day. Why the AI chose to include poppies so frequently may be in part due to their specific connection to death. In addition, perhaps art about palliative care often celebrates flowers because they can bring beauty and life into bleak or sterile environments and remind families of their loved ones.

Fig. 1. “Poppy.” Digital art of a poppy flower set against a seascape background.

The flowers often appeared next to another common theme: windows (Figure 2). These almost always have light shining through and are typically at the center of images beside beds or figures using walkers and wheelchairs. The emotionality and symbolism of windows resonate with my experiences talking with patients. Windows provide light, fresh air, and the views and sounds of a world these patients might be unable to explore anymore.

Fig. 2. “Windows.” Digital art of a hospital bed next to a set of windows with sunlight shining through.

A theme I had not expected was the blending of patients and providers. When the AI added human figures into its pieces, they were typically either a patient (typically older appearing, using a walker, wheelchair, or hospital bed) or a health-care provider (wearing scrubs or a stethoscope, often standing next to or above a patient). Sometimes, though, the AI seemed to “mix” these concepts. A doctor would be lying in a hospital bed or sitting in a wheelchair. One of my favorite pieces, Figure 3, shows a figure in scrubs looking at a painting of another doctor in a white coat sitting in a wheelchair. Several intriguing potential interpretations of this piece and theme come to mind. Palliative care health-care workers carry the privilege and emotional weight of caring for patients suffering or at the ends of their lives. Perhaps the artwork that blends patients and physicians reflects both populations’ potential mental health challenges. In addition, I have heard palliative care physicians talk about how their work regularly reminds them of their mortality and that of their loved ones. Alternatively, it may be that palliative care workers foresee themselves as future patients of their own specialty. This may represent a comforting, affirming faith in the profession’s future.

Fig. 3. “Identity.” Digital art of a physician looking at a portrait of another physician in a wheelchair.

The last motif I noticed, which often co-occurred with the others, is physical touch. Many pieces show health-care providers extending hands toward or holding patients (Figure 4). That the AI associates palliative care and physical touch is a beautiful outcome, for it means that such a simple gesture is meaningful enough to appear in artwork or narratives from actual patients, families, and artists.

Fig. 4. “Touch.” Digital art of many outstretched hands offering healing physical contact.

During the day-to-day practice of medicine, it may be easy to lose sight of victories and the beauty in the work. If so, I hope these AI art results are reassuring. Without additional prompting, palliative care is seen as a specialty of living well, providing escape, fostering connection, and a font of comfort and peace. To me, that is a result worth celebrating.