The treatment of Belgian artist Rik Wouters

1915 Wouters_portret_met_zwarte_ooglap.JPG 

"Self-portrait with black eye patch" by Rik Wouters, October 1915.  Following mutilating surgery on his upper jaw and right eye by Professor Rotgans, Rik Wouters paints this self-portrait.During the year up to his death he paints and draws in rapid tempo despite the hindrance of his illness, until his other eye is affected.

Rik Wouters (Mechelen, Belgium, 21 August 1882 - Amsterdam, 11 July 1916) was a Belgium sculptor and painter.  He was the son of a cabinet maker - wood carver in Mechelen, Belgium.  He practises his creativity with chisel and plane in the workshop of his father.  The eighteen year old Wouters studies art in Brussels and throws himself into the bohemian lifestyle of the early twentieth century.


"Self-portait with cigar", Rik Wouters 1913

With his healthy provincial appearance, blond hair, blue eyes, rosy complexion, full figure and spontaneous personality he stands out among his more artistic-looking friends.  The battle for recognition is hard. But Wouters lives in a stimulating time.  After the pointillists and James Ensor, many new artists are ready to change the art world.  Reforming artists rebel against the established order and meet together in associations such as Les XX en La Libre Esthétique.  Lenin is also to be found in this effervescent Brussels.  Soon, however, Wouters has problems with his heath and an alarming headache bothers him. This is thought to be due to a neglected infection of the sinuses following long periods of exposure to wood dust in the workshop of his father - a well-known occupational hazard among cabinet makers in Mechelen. Working with turpentine, cheap chemicals and poisonous paint thinners may have exacerbated his illness.

Wouters is pulled into the First World War.Just as things are going better for Wouters, who has held his first large exhibition and is selling his work, and has married his great love Helene (Nel) Duerinckx, war breaks out.  Wouters is called up and is part of a number of hopeless field battles.  He deserts for a time but nobody notices, such is the chaos in the Belgian army. With his platoon, Wouters finds himself in The Netherlands and is housed in Zeist in an internment camp in draughty barracks, without any creature comforts.  For Rik, the most difficult is not to be able to express his artistic temperament and that he only sees Nel occasionally. Frederik Van Eeden does come and visit and Cyriel Buysse contacts him.

Treatment in the Antoni van Leeuwenhoekhuis. In the camp in Zeist, Rik becomes very ill again.  He is allowed to leave the camp and live under more humane circumstances, but finally he is diagnosed with cancer in the upper jaw.  Together with his wife Nel, he moves into an apartment belonging to the family of Nicolaas Beets at Derde Kostverlorenkade 37, 3rd floor, in Amsterdam.  Friends and relations see to it that he is treated for free by a team of physicians under the leadership of surgeon Professor Jacob Rotgans.  Rik is admitted to the Prinsengracht hospital in Amsterdam and Jacob Rotgans in person operates on him there. Part of the jaw affected by tumour is removed and for postoperative irradiation he is referred to radiologist Gaarenstroom in the newly opened Antoni van Leeuwenhoek hospital of the Netherlands Cancer Institute (NKI).

1915 RW bij start behandeling.jpg 

In the NKI the condition of Rik Wouters is carefully noted prior to the irradiation treatment.  Apart from an extensive description, some clinical sketches have also been kept (see below).  The surgical scars from the jaw resection have been drawn in, as well as the removal of the lymph nodes.


Sketch condition Wouters at start of treatment in the AVL



Sketch with 10 irradiation fields

Gaarenstroom treats Rik Wouters with X-rays and radium on 10 adjacent fields, with which the whole upper jaw and the neck area are irradiated.  Information on the irradiation chart makes it possible to estimate the dose.

1915 wouters stralenkaart2.jpg 

Irradiation chart (nr 2 of 2, the first one is missing from the patient file) of Rick Wouters. 

The radiation treatments take place from about 1 to 16 November 1915 and two of the consecutive fields are irradiated per session.  The tube voltage is about 100 kV and the radiation filter is noted as being 5 mm of lead ?? (cannot be solid lead which would absorb the radiation).  The total dose given with X-ray irradiation was measured on the skin at 172 units according to the Holzknecht system.  Based on literature, this would equal 7883 röntgen or about 79 Gy. The 100 kV X-ray fields barely overlap so that the dose in the tissue from this irradiation chart is only 7H or about 320 r, with the exception of small areas of overlap. Very probably, just as many fields are listed on the missing chart.  But also the radium treatment is insufficient so that after a few months, secondaries appear in his eye socket.

Finally his right eye is removed.  After various operations, the artist's condition had deteriorated to such an extent that he was given morphine.  He had also become partly blind.  In spite of his hopeless situation, he still painted.  Wouters' surprising self-portrait is shown above this chapter, "Portrait of Rik with black eye-patch", on which his left eye is covered.  In reality it was his right eye; apparently he used a mirror to paint this.

But Rik Wouters was still alive.  In January and February of 1916 he held a large exhibition of all his work in the Municipal Museum (Stedelijk museum) of Amsterdam.  An interesting interview by Maria Viola, the art editor of the daily Algemeen Handelsblad, with the terminally ill artist, has been kept.  "I work when I can; if I'd always been well, I would have done so much more" she noted.  "Wonderful city, here; I am happy here, if God gives me health that I can keep busy".

In the night of 11 July 1916, Rik Wouters died at the Prinsengracht  hospital in Amsterdam.

Rik Wouters en Nel.jpg

Photo around 1915, Rik Wouters and his wife Helene (Nel) Duerinckx

For more information about the Flemish painter and sculptor Rik Wouters, see for example:

Rik Wouters on Wikipedia (with images of work)

Exhibition in the old townhall (Schepenhuis) in Mechelen (B) (in Dutch, with images of work)

or the following publications:



Bronnen & Publicaties

  • [79] “Rik Wouters, een biografie” by Eric Min, 2011, publ. De Bezige Bij, Antwerp. ISBN 978 908542 174 0 (Dutch) ,
  • [80] “De laatste levensjaren van Rik Wouters” by Dr. P.P. Devriese, ENT specialist, Academisch Medisch Centrum, Amsterdam. 1994. Tijdschrift Geschiedenis der Geneeskunde, March 1994, pp 58-64, Publ. Garant, Antwerp & Apeldoorn (Dutch) ,