This painting is inspired by Francisco Goya, on one of his etchings, Los Caprichos: Ensayos in 1799.
This was around the time when he became deaf. He was going through rough times and in pain. From his Ensayos work, there is a person putting hand in the ear. This reminds me of two Deaf persons and of other Deaf people who went through horrible times in emergency rooms, ambulances and even at doctors and dentists offices. The first question, 'are you interested in getting a cochlear implant?' while a Deaf patient is in pain.
Here in this painting, shows a spear pierced in the heart, meaning a heart attack. A Deaf person had a heart attack, rushing to a hospital, and inside an ambulance, a nurse asked if a Deaf patient was interested in getting a cochlear implant, while he was having a heart attack. Another Deaf person arriving at an emergency room, a doctor asked if a Deaf patient wants a cochlear implant and never mind the life threatening heart attack. The doctor's interest is putting a cochlear implant in the ear and not care enough to fix the broken heart. The elephant behind the wall is Alexander Graham Bell. This is a true story.
Here is an example of Goya's Los Caprichos: Ensayos
Here is a closeup of a hand in the ear.