Breuer felt himself flush. He could not hold her gaze any longer and looked away as she continued.
“What I mean to say is that perhaps I am guilty of being indirect simply to prolong our time here together.”
“More coffee, Fräulein?” Breuer signaled the waiter. “And more of these droll breakfast rolls. Have you ever reflected upon the difference between German and Italian baking? Allow me to describe my theory about the concordance of bread and national character.”
So Breuer did not hurry back to Mathilde. And as he took a leisurely breakfast with Lou Salomé, he mused upon the irony of his situation. How strange that he had come to Venice to undo the damage done by one beautiful woman and now sat tête-à-tête with another even more beautiful! He also observed that, for the first time in months, his mind was free of his obsession with Bertha.
Perhaps, he mused, there’s hope for me, after all. Perhaps I can use this woman to crowd Bertha off the stage of my mind. Can I have discovered a psychological equivalent of pharmacologic replacement therapy? A benign drug like valerian can replace a more dangerous one like morphine. Likewise, perhaps Lou Salomé for Bertha—that would be a happy progression! After all, this woman is more sophisticated, more realized. Bertha is—how to say it?—presexual, a woman manqué, a child twisting awkwardly in a woman’s body.
Yet Breuer knew that Bertha’s presexual innocence was precisely what drew him to her. Both women excited him: thinking about them brought a warm vibration to his loins. And both women frightened him: each dangerous, but in different ways. This Lou Salomé frightened him because of her power—of what she might do to him. Bertha frightened him because of her submissiveness—because of what he might do to her. He trembled when he thought of the risks he had taken with Bertha—how close he had come to violating the most fundamental rule of medical ethics, to bringing ruin upon himself, his family, his entire life.
Meanwhile he was so deeply engaged in conversation and so entirely charmed by his young breakfast companion that at last it was she, not he, who reverted to her friend’s illness—specifically to Breuer’s comment about medical miracles.
“I am twenty-one years old, Doctor Breuer, and have given up all belief in miracles. I realize that the failure of twenty-four excellent physicians can only mean we have reached the limits of contemporary medical knowledge. But don’t mistake me! I have no illusions that you can cure Nietzsche’s medical condition. That was not why I sought your help.”
Breuer put down his coffee cup and blotted his mustache and beard with his napkin. “Forgive me, Fraulein, now I am truly confused. You began, did you not, by saying you wanted my help because your friend is very sick?”
“No, Doctor Breuer, I said I had a friend who is in despair, who is in grave danger of taking his life. It is Professor Nietzsche’s despair, not his corpus, that I ask you to heal.”
“But, Fräulein, if your friend is in despair over his health and I have no medical therapeutics for him, what can be done? I cannot minister to a mind diseased.”
Breuer took Lou Salomé’s nod to mean she had recognized the words of Macbeth’s physician, and continued, “Fräulein Salomé, there is no medicine for despair, no doctor for the soul. There is little that I can do except to recommend one of a number of excellent therapeutic spas in Austria or Italy. Or perhaps a talk with a priest or some other religious counselor, a family member—perhaps a good friend.”
“Doctor Breuer, I know that you can do more. I have a spy. My brother, Jenia, is a medical student who attended your clinic earlier this year in Vienna.”
Jenia Salomé! Breuer tried to recall the name. There were so many students.
“Through him I learned of your love of Wagner, that you would be vacationing this week at the Amalfi Hotel in Venice, and also how to recognize you. But, most important of all, it was through him that I learned that you are, indeed, a doctor for despair. Last summer he attended an informal conference where you described your treatment of a young woman called Anna O.—a woman who was in despair and whom you treated with a new technique, a ‘talking cure’—a cure based on reason, on the unraveling of tangled mental associations. Jenia says you are the only physician in Europe who can offer a true psychological treatment.”
Anna O.! Breuer started at the name, and spilled coffee as he lifted the cup to his lips. He dried his hand with his napkin, hoping that Fraulein Salomé hadn’t noticed the accident. Anna O., Anna O.! It was incredible! Everywhere he turned, he encountered Anna O.—his secret code name for Bertha Pappenheim. Fastidiously discreet, Breuer never used his patients’ true names when discussing them with students. Instead, he constructed a pseudonym by moving a patient’s initials back one letter in the alphabet: thus B.P. for Bertha Pappenheim became A.O., or Anna O.
“Jenia was extraordinarily impressed with you, Doctor Breuer. When he described your teaching conference and your cure of Anna O., he said he was blessed to be able to stand in the light of genius. Now, Jenia is no impressionable lad. I’ve never heard him speak like that before. I resolved then that I should one day meet you, know you, perhaps study with you. But my ‘one day’ became more immediate when Nietzsche’s condition worsened over the past two months.”
Breuer looked around. Many of the other patrons had finished and left, but here he sat, in full retreat from Bertha, speaking to an astonishing woman whom she had brought into his life. A shiver, a chill, passed through him. Was there to be no refuge from Bertha?
“Fräulein”—Breuer cleared his throat and forced himself to continue—“the case your brother described was just that—a single case in which I used a highly experimental technique. There is no reason to believe that this particular technique would be helpful with your friend. In fact, there is every reason to believe it wouldn’t.”
“Why so, Doctor Breuer?”
“I’m afraid time does not permit a long answer. For now I shall simply point out that Anna O. and your friend have very different illnesses. She was afflicted with hysteria and suffered from certain disabling symptoms, as your brother may have described to you. My approach consisted of systematically wiping out each symptom by helping my patient to recall, with the help of mesmerism, the forgotten psychic trauma in which it originated. Once the specific source was uncovered, the symptom dissolved.”
“Suppose, Doctor Breuer, we consider despair to be a symptom. Couldn’t you approach it in the same manner?”
“Despair is not a medical symptom, Fraulein; it is vague, imprecise. Each of Anna O.’s symptoms involved some discrete part of her body; each was caused by the discharge of intracerebral excitation through some neural causeway. Insofar as you’ve described it, your friend’s despair is entirely ideational. No treatment approach exists for such a condition.”
For the first time, Lou Salomé hesitated. “But, Doctor Breuer”—again she placed her hand on his—“before your work with Anna O., there was no psychological treatment for hysteria. As I understand it, physicians used only baths or that horrid electrical treatment. I’m convinced that you, perhaps only you, could devise such a new treatment for Nietzsche.”
Suddenly Breuer noticed the time. He had to get back to Mathilde. “Fräulein, I shall do everything in my power to help your friend. Please allow me to give you my card. I shall see your friend in Vienna.”
She glanced only briefly at the card before placing it in her purse.
“Doctor Breuer, I’m afraid it is not so simple. Nietzsche is not, shall I say, a cooperative patient. In fact, he doesn’t know that I’m speaking to you. He is an intensely private person and a proud man. He’ll never be able to acknowledge his need for help.”
“But you say he speaks openly of suicide.”
“In every conversation, in every letter. But he doesn’t ask for help. Were he to know of our conversation, he would never forgive me, and I’m certain he would refuse to consult with you. Even if, somehow, I were to persuade him to consult with you, he’d limit the consultation to his bodily ailment
s. Never—not in a thousand years—would he place himself in the position of asking you to alleviate his despair. He has strong opinions about weakness and power.”
Breuer began to feel frustrated and impatient. “So, Fraulein, the drama becomes more complex. You want me to meet with a certain Professor Nietzsche, whom you consider to be one of the great philosophers of our age, in order to persuade him that life—or, at least, his life—is worth living. And, moreover, I must accomplish this without our philosopher knowing it.”
Lou Salomé nodded, exhaled deeply, and sat back in her chair.
“But how is it possible?” he continued. “Simply to accomplish the first goal—to cure despair—is in itself beyond the reach of medical science. But this second condition—that the patient be treated surreptitiously—transfers our enterprise to the realm of the fantastic. Are there other obstacles you have yet to reveal? Perhaps Professor Nietzsche speaks only Sanskrit—or refuses to leave his hermitage in Tibet?”
Breuer felt giddy but, noticing Lou Salomé’s bemused expression, quickly controlled himself. “Seriously, Fräulein Salomé, how can I do this?”
“Now you see, Doctor Breuer! Now you see why I sought out you rather than a lesser man!”
The bells of San Salvatore pealed the hour. Ten o’clock. Mathilde would be anxious by now. Ah, but for her. . . . Breuer again motioned to the waiter. As they waited for the check, Lou Salomé issued an unusual invitation.
“Doctor Breuer, will you be my guest for breakfast tomorrow? As I mentioned before, I bear some personal responsibility for Professor Nietzsche’s despair. There is a great deal more I must tell you.”
“Tomorrow is, I regret, impossible. It’s not every day that a lovely woman invites me to breakfast, Fraulein, but I am not free to accept. The nature of my visit here with my wife makes it inadvisable to leave her again.”
“Let me then suggest another plan. I’ve promised my brother to visit him this month. In fact, until just recently I had planned to travel there with Professor Nietzsche. Permit me, when I am in Vienna, to provide you with more information. Meanwhile, I shall try to persuade Professor Nietzsche to consult with you professionally about his deteriorating physical health.”
They walked together out of the café. Only a few patrons lingered as the waiters cleared away the tables. As Breuer prepared to take his leave, Lou Salomé took his arm and started to walk with him.
“Doctor Breuer, this hour has been too short. I am greedy and desire more of your time. May I walk with you back to your hotel?”
The statement struck Breuer as bold, masculine; yet from her lips it seemed right, unaffected—the natural way people should talk and live. If a woman enjoys a man’s company, why shouldn’t she take his arm and ask to walk with him? Yet what other woman he knew would have uttered those words? This was a different sort of woman. This woman was free!
“Never have I so regretted declining an invitation,” Breuer said, pressing her arm closer to him, “but it is time for me to return, and to return alone. My loving but concerned wife will be waiting at the window, and I have a duty to be sensitive to her feelings.”
“Of course, but”—and she drew her arm from his, to stand facing him, self-enclosed, forceful as a man—“to me, the word ‘duty’ is weighty and oppressive. I’ve pared down my duties to only one—to perpetuate my freedom. Marriage and its entourage of possession and jealousy enslave the spirit. They will never have dominion over me. I hope, Doctor Breuer, the time will come when neither men nor women are tyrannized by each other’s frailties.” She turned with all the assurance of her arrival. “Auf Wiedersehen. Till our next meeting—in Vienna.”
CHAPTER 2
FOUR WEEKS LATER, Breuer sat at his desk in his office at Bäckerstrasse 7. It was four o’clock in the afternoon, and he was impatiently awaiting the arrival of Fräulein Lou Salomé.
It was unusual for him to have a hiatus during his workday, but in his eagerness to see her, he had quickly dispatched his previous three patients. All had straightforward ailments requiring little effort on his part.
The first two—men in their sixties—suffered from virtually identical conditions: severely labored breathing and a rasping, dry bronchial cough. For years Breuer had treated their chronic emphysema which, in cold, wet weather, became superimposed with acute bronchitis, resulting in severe pulmonary compromise. For both patients, he prescribed morphine for the cough (Dover’s powder, five grains three times a day), small doses of an expectorant (ipecac), steam inhalations, and mustard plasters to the thorax. Though some physicians scoffed at mustard plasters, Breuer believed in them and often prescribed them—especially this year, when half of Vienna seemed to be down with respiratory illness. The city had seen no sun for three weeks, only a remorseless freezing drizzle.
The third patient, a house servant in the home of Crown Prince Rudolf, was a feverish, pockmarked young man with a sore throat, so shy that Breuer had to be imperious in ordering him to undress for an examination. The diagnosis was follicular tonsillitis. Though adept at quickly excising tonsils with scissors and forceps, Breuer decided these tonsils were not ripe enough to remove. Instead, he prescribed a cold compress to the neck, a potassium chlorate gargle, and carbonized water spray inhalations. Since this was the patient’s third sore throat of the winter, Breuer also advised him to harden his skin and his resistance with daily cold baths.
Now, as he waited, he picked up the letter he had received three days ago from Fraulein Salomé. As boldly as in her previous note, she announced that she would arrive at his office today at four for a consultation. Breuer’s nostrils flared: “She tells me what time she shall arrive. She issues the edict. She bestows upon me the honor of—”
But he quickly caught himself: “Don’t take yourself so seriously, Josef. What difference does it make? Even though Fraulein Salomé had no way of knowing, it happens that Wednesday afternoon is an excellent time to see her. In the long skein of things, what difference does it make?”
“She tells me. . . ”Breuer reflected upon his tone of voice: it was precisely this inflated self-importance that he detested in his medical colleagues like Billroth and the elder Schnitzler, and in many of his illustrious patients like Brahms and Wittgenstein. The quality he most liked in his closer acquaintances, most of whom were also his patients, was their unpretentiousness. That was what drew him to Anton Bruckner. Maybe Anton would never be the composer Brahms was, but at least he didn’t worship the ground under his own feet.
Most of all, Breuer enjoyed the irreverent young sons of some of his acquaintances—the young Hugo Wolf, Gustav Mahler, Teddie Herzl, and that most improbable medical student, Arthur Schnitzler. He identified with them and, when other elders were out of hearing, delighted them with caustic jabs at the reigning class. For example, last week at the Polyklinik Ball, he had amused the group of young men crowding about him by pronouncing, “Yes, yes, it is true that the Viennese are a religious people—their god is named ‘Decorum.’ ”
Breuer, ever the scientist, recalled the facility with which he had, in only a few minutes, switched from one mental state to another—from arrogance to unpretentiousness. What an interesting phenomenon! Could he replicate it?
Then and there he conducted a thought experiment. First he tried to slip into the Viennese persona with all the pomposity he had come to hate. By puffing himself up and silently muttering “How dare she!,” squinting his eyes and gritting his frontal cerebral lobes, he re-experienced the pique and indignation that envelop those who take themselves too seriously. Then exhaling and relaxing, he let it all slip away and stepped back into his own skin—into a state of mind which could laugh at itself, at its own ridiculous posturing.
He noted that each of these states of mind had its own emotional coloring: the inflated one had sharp corners—a nastiness and irritability—as well as a loftiness and loneliness. The other state, in contrast, felt round, soft, and accepting.
These were definite, identifiable emotions,
Breuer thought, but they were also modest emotions. What about more powerful emotions and the states of mind that brew them? Might there be a way to control those stronger emotions? Might that not lead to an effective psychological therapy?
He considered his own experience. His most labile states of mind involved women. There were times—today, ensconced in the fortress of his consulting room, was one of them—when he felt strong and safe. At such times, he saw women as they really were: struggling, aspiring creatures dealing with the endless pressing problems of everyday life; and he saw the reality of their breasts: clusters of mammary cells floating in lipoid pools. He knew about their leakages, dysmenorrheic problems, sciatica, and various irregular protrusions—prolapsed bladders and uteruses, and bulging blue hemorrhoids and varicosities.
But then there were other times—times of enchantment, of being captured by women who were larger than life, their breasts swelling into powerful, magical globes—when he was overcome by an extraordinary craving to merge with their bodies, to suckle at their nipples, to slip into their warmth and wetness. This state of mind could be overwhelming, could overturn an entire life—and had, in his work with Bertha, almost cost him everything he held dear.
It was all a matter of perspective, of switching frames of mind. If he could teach patients to do that at will, he might indeed become what Fraulein Salomé sought—a doctor for despair.
His reverie was interrupted by the sound of the door opening and closing in his outer office. Breuer waited a moment or two, so as not to appear overanxious, and then stepped into his waiting room to greet Lou Salomé. She was wet, the Viennese drizzle having become a downpour—but before he could help her out of her dripping outer coat, she was shrugging it off by herself and handing it to his nurse and receptionist, Frau Becker.
After ushering Fraulein Salomé into his office and motioning her toward a heavy black leather-upholstered chair, Breuer sat down in the chair next to her. He couldn’t help remarking, “I see you prefer to do things for yourself. Doesn’t that deprive men of the pleasure of serving you?”
When Nietzsche Wept Page 2