Elena Foulis and Julieta Manrique consider additional ways to understand people’s experiences with illness and pain beyond spoken languages, focusing on Manrique’s paintings of her experiences with fibromyalgia.
In 2010, Julieta Manrique, a Colombian artist, was diagnosed with fibromyalgia. It took multiple visits to doctors across Colombia, Italy, and the United States to receive her diagnosis. Her debilitating pain was untranslatable in many languages, and Manrique often felt discouraged by the lack of medical support and treatment for her conditions. Whether in Spanish, Italian, or English, her experiences with pain were repeatedly difficult to convey, often making her feel unheard. Indeed, her experience has been foundational in my own class on Latina/o/e language and culture in health at Texas A&M University in San Antonio. As a university with a large number of Latina/o/e students, many of whom are bilingual in English and Spanish, in this class, there is always an opportunity to consider our own positionality and experiences as we learn about people’s experiences of U.S. healthcare. While most of my students are not in healthcare careers, their personal insights on how they and their family members have navigated challenging encounters with healthcare settings make our discussions richer. Manrique’s visual art enables us to consider the visual and embodied representation of pain and illness, thereby allowing students to more easily comprehend the experience of living with pain.
Translating pain and illness
In Manrique’s case, Elaine Scarry’s (1985) discussion of pain and the difficulty of conveying how it feels in words helps us see how none of the languages accessible to her have been able to sufficiently articulate the complexity of her pain. Yet, one might wonder to what extent the medical institutions play a part in silencing the pain of immigrants and black and brown communities. It is well documented that minoritized communities often experience a credibility deficit, which calls into question their capacity as knower (Fricker 2007), so what they express of their experience, and how they express it, are often dismissed.
Scarry (1985, 7) asserts that, “to have pain is to have certainty; to hear that another person has pain is to have doubt.” Pain, as Scarry argues, destroys language or, in this case, languages, rendering us unable to articulate our suffering. Even in her native language, Spanish, with words such as dolor agudo [sharp pain], asfixiante [suffocating pain], punzante [stabbing pain], opresivo [crushing pain], or profundo [deep pain], Manrique felt unable to truly convey the way she experiences pain. Realizing that she might never be able to describe how she felt in words, she opted to visualize it, thereby rendering its complexity tangible, for herself and others. Scarry (1985, 27) explains that “[t]he physical pain is so incontestably real that it seems to confer its own quality of ‘incontestable reality’ on that power that has brought it into being.” This is represented in Manrique’s painting, Restless Pain, which we discuss next.
In the Fall of 2025, I had my students study Manrique’s paintings to consider and more fully grasp how patients lack the words to capture the depth of their embodied experiences of pain and associated symptoms. We also considered Manrique’s own positionality as Colombian immigrant woman who now resides in the U.S., and whether the fact that we were a class comprised entirely of women, and all Latina, could help us be more attuned to her medical conditions. While we thought about our own differences in age, citizenship, and life stages (single, married, new moms, etc.), it was evident that many of us connected with her experience within the U.S. healthcare system. We focused our analysis on the following three paintings: Restless Pain, Inside and Outside the Medical System After 2 Seizures, and Al Sad, Sondos, McCamey, Kendra MD.
The body in pain
In order to engage in alternative ways of understanding pain and illness, I had the students look at Manrique’s paintings, which one student immediately compared with Frida Kahlo’s paintings of her broken back. Students commented on her use of graphs, angles, and barcodes as something unexpected, which asked them to pay attention to understanding her story more fully. For example, in Restless Pain, Manrique utilizes the silhouette of her body, using blue, green, and yellow colors in different shades. The colors, patterns, and small print invite us to look closer, to zoom in, read, and pause to take it all in. Since students were able to study the paintings closely, they commented on the different languages found in the description of her diagnosis and noted the effect the colors had on them, such as creating sadness and empathy. Manrique describes the color blue as representing water, dreams, and rest. The yellow found in the body is the energy and slow, violent movement of pain as it passes through her body, while also alluding to the body’s positive energy as it fights to stay alive.
This painting was created a year after her first hip surgery. In it, Manrique shows the frustration from being misunderstood when she describes her pain, and her own barriers in being able to navigate the healthcare system in three countries (Colombia, Italy, and the United States) and languages. As we see in the painting, three languages were not enough for her to understand what was happening to her body, and the color contrast against the writing makes it look a bit blurry, as if the words themselves could not provide a concrete expression of her experience. Manrique wanted to convey the feeling of confusion as a patient who had to attend many doctors’ appointments, health exams, and procedures, and still could not really obtain a diagnosis. Indeed, seeing the picture from afar transmits this feeling of confusion for the viewer, who needs to look closer to understand the position of the body and read the words. Her experience becomes untranslatable even when she adds information about her condition in Spanish, English, and Italian, signaling her own search for answers and the words she used to express how she felt.
Reproduced with permission.
The second painting consists of two parts. It is titled Inside and Outside the Medical System After 2 Seizures, and it was donated to Dr. Pierre Giglio in the neuro-oncology department of the Wexner Medical Center. The painting was created in 2016, as a result of Manrique’s convulsions, when she almost bit through her tongue. It reflects the impossibility of putting into words the fear felt during a seizure episode, flitting in and out of consciousness, and having to make multiple hospital visits. It likewise depicts not knowing why she developed cysts, the medications that caused seizures, and the customer satisfaction surveys given to patients. We can also see barcodes and her medical tag. The painting looks busy, non-linear, filled with information that is hard to describe. She includes long descriptions of conditions, a hospital wristband, and large prints representing scanned portions of the brain (i.e lateral view, parietal lobe, frontal lobe, etc.). The painting shows a nude woman’s back, but the body appears more than once, and from different angles. We do not see her head, only an enlarged brain painted from different perspectives. Indeed, the overload of items, images, and colors is a representation of experiences with illness and health events that spoken or written languages cannot capture in their fullness.
In the above painting, called Al Sad, Sondos, McCamey, Kendra MD, Manrique pays homage to the two doctors who were most attuned to her pain and condition. The painting shows a body at rest, but portions of it have exposed bones. It features over-exposed layers of acrylic paint to outline the body. This is Manrique’s own body, and the over-exposed reds, oranges, and ochre tones are used to indicate blood and pain. For her, pain can be described as blood bubbling, or at the onset of boiling. We can also see translucent, white pieces of paper that look like gauze against the canvas’ texture, which highlight the names of health personnel, medications, diagnoses, and phone numbers. Importantly, in her work, Manrique highlights the body parts where pain concentrates, her own research on her diagnosis and medications, and the barcodes of each exam or procedure. In this painting, too, she included long descriptions of her conditions and identifies parts of the body by name. These body parts are represented from different angles throughout the painting.
Manrique’s paintings become a form of translating her body in pain into images that provide the viewer with a more in-depth understanding of her experience. Indeed, her art not only lets her express her pain, but serves as invitation to feel with her. While she provides a critical view of how the medical environment often treated her as a number—a barcode to scan—and evaluated her experience through recovery and healing via the data provided by clinical measurements, her art helps us see and feel how she makes sense of her own condition.
Scarry (1985, 164) explains how imagining objectifies the reality of pain because “through that relation [imagining and pain], pain will be transformed from a wholly passive and helpless occurrence into a self-modifying, and when most successful, self-eliminating one.” That is, Manrique uses her art to reconcile her own feelings of confusion about what is happening to her, and the alienation she feels when she explains her pain in words. While it is true that her pain is not gone, her agency to convey her experience is regained through art. In her paintings, Manrique makes visible this relationship between pain and imagination, since these:
constitute extreme conditions of; on the one hand, intentionality as a state and on the other, intentionality as self-objectification; and that between these two boundary conditions all the other more familiar, binary acts and objects are located. That is, pain and imagining are the “framing events” within whose boundaries all other perceptual, somatic, and emotional events occur; thus, between the two extremes can be mapped the whole terrain of the human psyche. (Scarry 1985, 165)
For example, when we experience hunger or are cold, imagining the object that would eliminate the condition of pain, such as food or a blanket, can transform the experience of pain into a pleasurable one. Pleasure here is understood as taking back her own narrative of pain through the act of painting. The corporeality of Manrique’s pain is insufficiently described in Spanish, English or Italian, but painting about it allows her to name her condition and evidence her experience.
Language and health
Since her diagnosis of fibromyalgia, Manrique has experienced other symptoms, surgeries, and medical encounters that often left her thinking about how doctors or the healthcare environment frequently forgot that her embodied pain was part of her daily experiences. She felt that she was not always treated with compassion and dignity. Glenn Martínez (2020) stresses the role that language plays among Latino patients, and its direct impact on positive or negative health outcomes. Martínez argues that although many studies point to language as a social determinant of health, this does not quite capture the experiences of Latino patients. He writes, “the unidirectional nature of the model and its bias towards causation as opposed to interaction leads us to question its ability to adequately capture the multilayered and complex relationship between Spanish and Latino health” (Martinez 2020, 24). Importantly, one might consider how art can in fact capture this multilayered and complex relationship between language and health. Manrique’s visual expression of her conditions invites us to explore an additional venue in which to recognize patient’s experiences, not as a replacement for their narrative but as supplemental to it.
Indeed, in thinking about the role of narrative medicine, which Rita Charon (2006, 21) describes as “medicine practiced with these narrative skills of recognizing, absorbing, interpreting, and being moved by the stories of illness,” we argue that for some communities, narrative encounters are not always moments of understanding, given the presence of power imbalances between patient and healthcare provider, and the language ideologies that might be present. Importantly, Mihelakis and Toth’s (2025) new work challenges us to expand our imagination of health humanities across borders and languages, and to examine the “dynamics between marginalized and dominant groups” and put together embodied experiences of health and illness (Mihelakis and Toth 2025, 10). That is, seeing the body and the arts as venues that can help patients make sense of their experiences with disease, pain, and trauma. Crucially, for U.S. Latina/o/e communities, this starts when clinicians and healthcare providers adopt a linguistically and culturally informed approach to understanding how patients express their own symptoms. We find that works by visual and performing artists can help bridge this language gap in narrative medicine, allowing patients to express their own journeys and generating moments of deep reflection among healthcare providers.
About the authors
Elena Foulis is Associate Professor and director of the Spanish language studies at Texas A&M University–San Antonio. Her monograph, Embodied Encuentros: Oral History Archives of Latinas/os/es Experiences, with Ohio State University Press, will be available in April 2026. Foulis is an engaged scholar, committed to reaching non-academic and academic audiences through her writing, presentations, and public humanities projects.
Julieta Manrique is a visual artist based in Columbus, Ohio. She completed her MA in visual art at the Universidad Nacional de Colombia and an MA in history at the Universidad Javeriana de Bogota, Colombia. She has exhibited her work at several galleries in Colombia, Italy, and the United States.
References
Charon, Rita. 2006. Narrative Medicine: Honoring the Stories of Illness. Oxford University Press.
Fricker, Miranda. 2007. Epistemic Injustice: Power and the Ethics of Knowing. Oxford University Press.
Martínez, Glenn A. 2020. Spanish in Health Care: Policy, Practice and Pedagogy in Latino Health. Routledge.
Mihelakis, Eftihia, and Lucille Toth, eds. 2025. Embodied Narratives in the Health Humanities and Literary Studies. University of Toronto Press.
Scarry, Elaine. 1985. The Body in Pain: The Making and Unmaking of the World. Oxford University Press.
