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The “Mona Lisa” has her own room in the Louvre, where she attracts six million visitors each year. Her room is frequently crowded with frenzied guests attempting to catch a glimpse of her enigmatic smile. Over a year ago, Boston physician Dr. Mandeep R. Mehra was in that endless line, hoping to do the same. During the long wait, he pondered the details of La Giaconda’s strange looks — her yellowing skin, her thinning hair, and of course, her lopsided smile.
In that time, he came to a realization: This woman is ill.
“I had the chance to just stand there for an hour and a half staring at nothing but this painting,” Mehra, medical director of the Heart & Vascular Center at Brigham and Women’s Hospital, tells Inverse. “I’m not an artist. I don’t know how to appreciate art. But I do sure know how to make a clinical diagnosis.”
Over the next year, Mehra dug into the history of Lisa Gherardini, the woman in the legendary portrait, as well as the public health records of historical and modern-day Florence, where the painting was created. As he outlines in a new paper in the Mayo Clinic Proceedings journal, Gherardini suffered from an ailment that is still common — and quite treatable — today.
When you are stuck in a small room at the Louvre, looking very closely at the “Mona Lisa,” says Mehra, you start to notice a lot of strange details.
Take, for example, the inner corner of her left eye: There’s a small, fleshy bump there, just between her tear duct and the bridge of her nose. Her hair is oddly thin and lank, and her hairline is receding behind her veil. She has no eyebrows whatsoever.
If you look closely at the whites of her eyes, you’ll notice they are abnormally yellow — far more so than her skin.
The right side of her neck has a faint but visible bulge, and her face is slightly puffy.
And on her right hand, folded delicately over her left, there’s a noticeable lump between her index and forefinger.
“It became clear to me that there was something wrong with her,” says Mehra.
This diagnosis — common in women who had just had a baby, like Ghirardelli — even explains the perplexing smile of the “Mona Lisa.” While previous historians had tried to chalk it up to Bell’s Palsy, a form of temporary facial paralysis that weakens the muscles in one of half of the face, Mehra says this explanation doesn’t hold because there’s no unevenness in the rest of her face.
His hypothyroidism diagnosis, however, accounts for her inscrutable expression, and casts a certain sadness over the portrait.
“The more characteristic reason for why that smile is not a full-blown smile or is partially asymmetric is probably hypothyroidism,” he says, “because when you have hypothyroidism you’re a little depressed, and your facial muscles are puffy and weak. You can’t even bring yourself to a full smile.”