Sir Luke Fildes's eldest son Phillip died Christmas morning, 1877. He was attended by Dr. Murray, who directed all of his attention and care to the patient during the child's fatal illness. This unswerving dedication impressed Fildes.

Ten years later, when Sir Henry Tate commissioned Fildes for a painting to exhibit in what was to become the Tate Gallery, Fildes was given freedom to choose the subject matter. Fildes immediately decided to depict this scene of a family physician holding a bedside vigil by a seriously ill child. However, the painting was not begun for four years, and then only at the urging of Tate.

The shade of a lamp is tilted so as to bestow light on the two central figures: the physician, and especially, the recumbent child. The physician faces away from the bottled medicine and cup on the table and directs his gaze fully on the child. He is dressed neatly and sits calmly, patiently, resting his bearded chin on his hand.

The small child is central in the picture, in a white nightshirt on a large white pillow and covered with pale blankets. The makeshift bed consists of two unmatched dining room-type chairs. The child's hair is tousled and the left arm flung out, with hand supinated and beyond the edge of the pillow. Nonetheless, the child rests quite peacefully, as the pose appears quite natural.

To the right and rear of the painting are the parents. They are placed in such deep shadows that it is frequently difficult to make out these figures in reproductions. The mother sits at a table and hides her face in her clasped hands. The father stands beside her, with a comforting hand on her shoulder, as he gazes at the physician.

The painting is set in the interior of a small cottage. Rafters are low, furniture simple. Colors are muted; earth tones predominate. Although the majority of the light comes from the lamp, a bit of light also enters from the recessed window near the mother.