▁an est h etic . ▁In ▁the ▁background , ▁the ▁operating ▁room ▁nur se , ▁Mary ▁C ly mer , ▁and ▁University ▁of ▁Pennsylvania ▁medical ▁school ▁students ▁observe . ▁E ak ins ▁placed ▁himself ▁in ▁the ▁painting ▁– ▁he ▁is ▁the ▁right most ▁of ▁the ▁pair ▁behind ▁the ▁nur se ▁– ▁although ▁the ▁actual ▁painting ▁of ▁him ▁is ▁attributed ▁to ▁his ▁wife , ▁Susan ▁Mac d ow ell ▁E ak ins . ▁The ▁painting , ▁also , ▁records ▁the ▁significant ▁transition , ▁in ▁just ▁ 1 4 ▁years , ▁from ▁the ▁earlier ▁status ▁qu o ▁– ▁the ▁participants ' ▁black ▁fro ck ▁co ats ▁represented ▁in ▁The ▁G ross ▁C lin ic ▁( 1 8 7 5 ) ▁– ▁to ▁the ▁" white ▁co ats " ▁of ▁ 1 8 8 9 . ▁ ▁The ▁painting ▁is ▁E ak ins ' s ▁largest ▁work . ▁It ▁was ▁commission ed ▁for ▁$ 7 5 0 ▁( equ ivalent ▁to ▁$ ▁today ) ▁in ▁ 1 8 8 9 ▁by ▁three ▁under grad uate ▁classes ▁at ▁the ▁University ▁of ▁Pennsylvania , ▁to ▁honor ▁Dr . ▁Ag new ▁on ▁the ▁occasion ▁of ▁his ▁ret irement . ▁The ▁painting ▁was ▁completed ▁quickly , ▁in ▁three ▁months , ▁rather ▁than ▁the ▁year ▁that ▁E ak ins ▁took ▁for ▁The ▁G ross ▁C lin ic . ▁E ak ins ▁car ved ▁a ▁Latin ▁ins cription ▁into ▁the ▁painting ' s ▁frame . ▁Trans l ated , ▁it ▁says : ▁" D . ▁Hay es ▁Ag new ▁M . D