Van Gogh began work on a portrait of Dr. Gachet two weeks after meeting him. He liked the doctor, but as he explained in a letter to his brother Theo, he saw no great benefit from being in his care; in fact, he suggested the doctor’s own nervous problems were as serious as his own. At this time Van Gogh was painting with great speed and urgency, often producing one canvas a day. When the doctor responded favourably to his portrait, Vincent immediately set about painting a second version. Though the doctor appears somewhat melancholic in this painting, Van Gogh later wrote of the expression being “sad... yet clear and intelligent”, as he felt some portraits ought to be.
The first Portrait of Dr. Gachet brought one of the highest prices ever paid for a painting. Ensuring it remained in private hands, Siegfried Kramarsky, a German-born New York philanthropist and owner of the Lisser & Rosenkrantz Bank, sold it to Japanese businessman Ryoei Saito on 15 May 1990 for US $82.5 million.