The first thing you notice about Betsy Clayton’s house in Dresher are the gardens. Even in the midst of an August heat wave, they’re lush with blooms: golden black-eyed Susans, dancing pink cleomes and purple loosestrife, and a spectacular white tree hydrangea thick with immense cone-shaped flower heads. She does it all herself, though a teenaged grandson helps with some of the harder chores, like pruning.

The garden extends from the front to the back of her house in Philadelphia’s Montgomery County suburbs, where it’s framed by a wall of windows in her family room like an immense mural—a mural she can’t see.

At the age of 30, with eight children, Clayton learned that she was going blind. She has a genetic, early-onset form of macular degeneration, an incurable eye disease that leads to the deterioration of the macula, a small, central part of the retina that controls visual sharpness in the center of the eye. She still has some peripheral vision, but the disease has already robbed her sister, Carol Saylor, of most of her sight.

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Mexican artist Frida Kahlo, who struggled all her life with the aftereffects of physical trauma—childhood polio and  a near-fatal bus accident that shattered her pelvis and broke her spinal column—once wrote, “I’ve done my paintings well. . . and they have a message of pain in them.”

Pain is not quite as in evidence in the works of noted Philadelphia painter and printmaker Gerard “Jerry” Di Falco, except in the quartet of assemblages on wood he calls, “Pain.” The painted and gilded animal skulls and bones—and a seed pod resembling a twisted spine—hang in the ninth floor Cherry Street apartment in Philadelphia that he shares with partner of 26 years, Ron Funk.

Di Falco, whose work is displayed in dozens of museums and private collections around the world, has been in almost constant pain for the past 35 years, the result of degenerative disk disease, including multiple herniations, scoliosis, and stenosis. He also has reflex sympathetic dystrophy syndrome (RSDS), sometimes called complex regional pain syndrome, a rare disorder in which the nervous system sends punishing nerve impulses to parts of the body, often the extremities, causing burning pain, touch and temperature sensitivity and muscle weakness. 

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