in the hope of being used as models, the final painting of the doctor resembles Fildes himself. Paying tribute to his family origins in the fishing industry, Fildes adds a fishing net hanging from the ceiling. His father was a mariner and shipping agent. On Queen Victoria's orders The cottage setting has led some to believe that the painting was ordered by Queen Victoria to honour her own physician, Sir James Clark. This alternative account also originates in the story about her physician being sent to Balmoral to care for the sick child of a servant. This account, however, is simply groundless because not a single contemporary reviewer mentioned this episode when the picture was first exhibited in 1891 at the Royal Academy in London and Fildes himself made no mention of Queen Victoria in his several interviews concerning the painting. Social context 18th and 19th century concerns by society of the rise of scientific medicine also could have possibly influenced the format of the painting. Composition Preparation The painting was first exhibited in 1891. Prior to completion, a number of sketches were made which are preserved at the Tate Gallery and depict various alternative compositions such as the doctor being on the right side of the canvas, the child seated rather than lying down, and different facial expressions for the doctor. Fildes built a model cottage to copy after visiting numerous cottages in north-east Scotland, ensuring that the picture included authentic detail of roof rafters, tablecloth, lampshade, and lighting. Particular attention was paid to ensuring the room had a poor, Victorian, multi-purpose appearance. Doctor and patient The focus of the picture is the worried but sympathetic physician and the sick child, with everything else in the shadows. The child had experienced a 'crisis', the critical stage of a potentially life-threatening illness. The ' dawn' light through the window, represents recovery and hope as the child survived the night. The concentrated focus of the doctor on the child shows the patient as a person and individual and the doctor as a compassionate carer with empathy for the patient's suffering. In 2002, Douglas wrote in the British Medical Journal, "So his manner is all, and Fildes captures it forever: the furrowed brow; the hand propping the firm bearded chin; the calm, concerned authority". Parents The parents are insignificant, helpless, and not central to the picture. A father gives support to his