This is one of the oddest oddball images in the history of American folk art, but it is an offshoot of a portrait tradition that is very common. Ammi Phillips, the artist, was one of the most prolific painters of his generation. He was born in Connecticut in 1788, and by 1811 he was establishing himself as a portrait painter in eastern New York State. Phillips had a penchant for finding newly prosperous middle-class entrepreneurs, those who came to the then-wilds of New York after the Revolutionary War to start settlements and take advantage of the plentitude of timber and water power. Over the course of his fifty-year painting career, Phillips would create likenesses of this generation as well as that of their children and grandchildren who had more genteel pursuits. He died in 1865.
Here is a Phillips portrait of a mother and child that we have in the Fenimore Art Museum collection. You can see why he was so popular. These paintings are simple and elegant, with solid colors and graceful lines. We think this portrait was painted sometime in the 1820s.
The portrait of the physician (in a private collection) is also from this period, but it is in a class by itself for what it shows. Of course, Phillips' patrons were justly proud of their accomplishments, and often had him include references to the source of their prosperity in their portraits. In this case, a simple book just wouldn't do. The good doctor here had to have his portrait painted in the act of a surgical procedure, in this case a surgery to repair a cataract. Honestly, I didn't even know that this type of surgery was performed in the 1820s, but here it is.
If you want to know more, you should be aware of the article "Folk Art Portraiture of Early American Surgeons," by Ira M. Rutkow, MD, published in Archives of Surgery in July 1999, available here by subscription to the journal. Otherwise, just enjoy this unusual painted document of 19th-century medicine and be glad you were born much later.