In The Face of Pain (Latin: Facies Dolorosa), Dr. Hans Killian, a respected German physician and diagnostician, presented a distinctive photographic exploration of patient suffering within the clinical context of the University Hospital of Freiburg in 1934. Originally conceived as a medical text, this work of 64 black-and-white portraits of hospitalized patients—men, women, and children of various ages—was intended to illustrate and catalog the ways in which illness manifests on the face, particularly through facial expressions. It sought to document the external presentation of patients as a crucial step in diagnosis.
Set against the cultural and historical backdrop of early Nazi-era Germany, The Face of Pain emerged during a period when boundaries between scientific objectivity and artistic expression were stringently maintained. Killian’s photographs, however, broke these conventions by deliberately blending empirical observation with empathetic portrayal, reflecting an evolving consideration of the physician-patient relationship. The project blurs the line between living and dead, and the progression of illness sometimes shown in multiple images further underscores the transient nature of life and health.
Killian’s aesthetic approach is notably unconventional for clinical photography. Images are framed closely, often at eye-level with the patient and from a side perspective, creating a compassionate viewpoint typically associated with familial intimacy rather than medical examination. Rendered in monochromatic collotype printing, the photographs' subdued grayscale palette imparts a cold, statue-like quality that further enhances the tension between life and death.
Published in 1934 and reissued in 1956 and 1967, The Face of Pain now sits between medicine and art—taught in medical-humanities, cited in photobook histories, and occasionally exhibited in photo-historical and library contexts. Later presentations emphasize the original book: made for diagnosis, now read as art.
