 Different theories exist as to the painting's origin but it is most likely based upon Fildes' own experience of the death of his son.Critics have noted that Fildes omitted common medical equipment of his era in order to focus on the relationship between physician and patient.The painting was commissioned by Henry Tate in 1890 as a work of "social realism" on a topic of Fildes' choosing to be displayed in the National Gallery of British Art, now known as the Tate Gallery London.